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Persistent Unilateral Sore Throat: Should It Be Included in the 2-Week Wait Referral Criteria by NICE
Ahmed Allam1,2, Hazem Nijim3
1Otolaryngology Department, Sheffield Teaching Hospitals NHS Trust, UK.
Design And Setting:
A retrospective study was conducted on all 2WW referrals made to our tertiary head and neck centre in a 12-month period.
Methods:
Sensitivity, specificity, and PPV of presenting complaints in H&N cancer diagnosis using Excel® and the statistical package SPSS®.
Results:
The sensitivity and specificity of 2005 NICE guidelines in detecting H&N cancers were 91.2% and 59%, respectively; their PPV was 9%. The sensitivity and specificity of 2015 NICE guidelines were 75.4% and 71%, respectively; their PPV was 10.3%. Eight out of 85 patients who presented with unilateral sore throat for more than 4 weeks, with or without otalgia and normal otoscopy, had H&N cancer (PPV 9.5%).
Conclusions:
Although the 2015 NICE guidelines have a high rate in detecting H&N cancers, consideration of reincluding unilateral sore throat in the referral criteria might be necessary.
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