To evaluate the diagnostic pathways for patients with malignant neck masses and identify factors associated with longer diagnostic intervals.
Approach:
Key Findings:
5% of patients referred for neck masses were diagnosed with malignancy.
Median interval from first primary care evaluation to pathologic diagnosis was 21 days, with 25% of patients having intervals of at least 38 days.
Empiric antibiotic use was associated with longer diagnostic times (41 days vs. 20 days without antibiotics).
58% of patients had biopsy performed at the initial specialist visit; follow-up biopsies increased diagnostic intervals by a median of 9 days.
Only 18% of patients followed the streamlined diagnostic pathway, achieving diagnosis in a median of 6 days.
Interpretation:
The study highlights inefficiencies in the diagnostic process for malignant neck masses and suggests that adherence to streamlined pathways may reduce diagnostic intervals.
Limitations:
Retrospective design and unadjusted exploratory comparisons.
Inclusion of patients only diagnosed with malignancy without a comparator group of benign cases.
Findings reflect practice patterns from 2017 and do not account for patient-related delays or out-of-system encounters.
Conclusion:
The findings establish baseline data for performance improvement and support further study on the impact of expedited diagnostic pathways on patient outcomes.
