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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
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Description
Sputum culture and sensitivity is a medical procedure used to diagnose bacterial infections in the respiratory tract and select the most appropriate antibiotics for treatment. This process involves analyzing sputum samples of thick and opaque secretions produced in the lungs and airways. These samples are collected from patients and then sent to the laboratory for analysis.
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Two week waits: What are we waiting for?

Ahmed R Abdelraheim1, Mohammed Khairy2, Mo'men Mohammed2

  • 1Department of Obstetrics and Gynaecology, Faculty of Medicine, Minia University, Egypt; Gynaecological Oncology unit, Queen's Hospital, Romford, UK.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
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PubMed
Summary

The two-week wait (2WW) referral system for gynecological cancers has a low predictive value, especially for premenopausal women. Improving referral criteria with risk factors is crucial for better patient prioritization and management.

Keywords:
2 week waitGynaecological malignancyRapid access gynaecology clinic

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Area of Science:

  • Gynecologic Oncology
  • Cancer Diagnostics
  • Healthcare Systems Analysis

Background:

  • The two-week wait (2WW) referral system aims to expedite diagnosis for suspected cancers.
  • Evaluating the effectiveness of the 2WW system in gynaecology is essential for optimizing patient pathways.
  • Identifying risk factors for gynecological cancers can improve diagnostic accuracy and triage.

Purpose of the Study:

  • To assess the efficacy of the 2WW referral system for gynaecological cancers.
  • To determine the positive predictive value (PPV) of 2WW referrals for specific gynaecological malignancies.
  • To identify key risk factors for endometrial cancer to refine urgent referral criteria.

Main Methods:

  • Retrospective analysis of 1105 women referred via the 2WW system over one year.
  • Inclusion of data for gynaecological malignancies diagnosed through non-urgent referrals for comparison.
  • Statistical analysis to compare predictive values between premenopausal and postmenopausal women.

Main Results:

  • The overall PPV for gynaecological malignancy via 2WW referrals was 8.33%.
  • PPVs were notably lower in premenopausal women (1.86%) compared to postmenopausal women (9.89%).
  • More cancers were diagnosed via the non-urgent system (95) than the 2WW system (92).
  • Risk factors for endometrial cancer include diabetes, increased endometrial thickness, prolonged bleeding, and advanced age.

Conclusions:

  • The 2WW referral system for suspected gynaecological cancers demonstrates low predictive value, particularly in premenopausal women.
  • Current referral criteria require modification to incorporate established risk factors.
  • Refined criteria can enhance prioritization of urgent appointments and improve subsequent management strategies.