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.
These 10 states have paid family or medical leave programs and health, wellness, peer support, or monitoring resources available to physicians or other health professionals.
