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Modifierad brittisk modell kortade ledtid till datortomografi av kolon
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping. Region Östergötland, Center for Health and Developmental Care, Patient Safety.
Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis.
Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
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2015 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112Article in journal (Refereed) Published
Abstract [en]

The British national Institute for Health and Care Excellence (NICE) has presented guidelines based on signs and symptoms which should raise a suspicion of colorectal cancer. A slightly modified version of these guidelines, adapted to Swedish conditions, named Swedish NICE (sNICE) criteria, was implemented at eight primary care centres. By following the sNICE criteria, cases with higher degree of suspicion of colorectal cancer were advised for computer tomography (CT) of the colon, whereas cases of low degree of suspicion were advised for the considerably less time and patient demanding CT of the abdomen. For patients with isolated anal symptoms without presence of sNICE criteria, active expectancy for six weeks was recommended, followed by renewed consideration. Results showed that the ratio between CT colon and CT abdomen was reduced from 2.2 to 1.1 after introduction of the sNICE criteria. Also, the proportion of patients undergoing CT colon within two weeks from admittance was increased from 3 to 25 %. We conclude that the sNICE criteria may be a useful supportive tool for the primary care physician.

Abstract [sv]

Vid misstanke om kolorektal cancer är det angeläget att patienter där misstankegraden är hög får genomgå snar utredning och diagnostik. På många håll i landet föreligger oönskat långa väntetider för sådan utredning.

Användningen av ett evidensbaserat beslutsstöd för kolonutredning, baserat på riktlinjer från brittiska NICE (National Institute for Health and Care Excellence), implementerades på 8 vårdcentraler i Östergötland.

Efter implementeringen förkortades ledtider till datortomografi av kolon, diagnos och behandling.

Beslutsstödet bidrog till att patienter där graden av misstanke om kolorektal cancer var låg kunde styras om till att genomgå datortomografi av buken i stället för av kolon.

Place, publisher, year, edition, pages
Stockholm, Sweden: Läkartidningen Förlag AB , 2015. Vol. 112
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:liu:diva-126059PubMedID: 26485132OAI: oai:DiVA.org:liu-126059DiVA: diva2:911577
Available from: 2016-03-14 Created: 2016-03-14 Last updated: 2016-04-25Bibliographically approved

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Falk, MagnusSjödahl, RuneWiréhn, Ann-BrittLagerfelt, MarieWoisetschläger, MischaMyrelid, Pär
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Division of Community MedicineFaculty of Medicine and Health SciencesResearch & Development Unit in Local Health CareDivision of Clinical SciencesDepartment of Surgery in LinköpingPatient SafetyDivision of Health Care AnalysisDivision of Radiological SciencesDepartment of Radiology in Linköping
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Läkartidningen
Radiology, Nuclear Medicine and Medical Imaging

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