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Table 3 Clinicians’ identified top 10 solutions for delayed diagnosis in primary care

From: Clinician-identified problems and solutions for delayed diagnosis in primary care: a PRIORITIZE study

Rank Suggestions for solutions to delayed diagnosis in primary care Total priority score Type of interventions to decrease delayed diagnosis Breakdown points in the diagnostic process
1 To have more rigorous systems in place for communicating abnormal results to patients 92.3 Structured-process change Follow-up
2 Direct hotlines to specialists to discuss patient problems 91.4 Structured-process change Referral & consultation
3 Clear referral guidelines and pathways for other common conditions (not just cancer) 88.4 Structured-process change Referral & consultation
4 Improve handovers 86.9 Structured-process change Referral & consultation
6 To have “affordable” GP update courses 86.3 Educational intervention Patient-practitioner encounter
5 Better training of GPs in spotting warning signs of serious conditions, diagnosis that are easily missed and safety netting 86.3 Educational intervention Patient-practitioner encounter
7 Review of every delayed diagnosis to learn how, why and whether it could be prevented in the future 85.4 Additional review & education NA
8 Better ways of informing patients that their results are ready and what the next best steps would be 84.8 Structured-process change Follow-up
9 Training in decision making and reinforcing the concept on ongoing reflection to continuous consideration of differential diagnosis 84.5 Educational intervention Patient-practitioner encounter
10 Have easier access to secondary care for the patients that GPs are worried about 83.9 Structured-process change Referral & consultation
  1. (Clinicians scored solutions using the following criteria: feasibility, cost-effectiveness and potential for saving lives (Table 1). The scoring options were 1 for “yes (e.g. this solution is feasible)”, 0 for “no (e.g. this solution is unfeasible)”, 0.5 for “unsure (e.g. I am unsure if this solution is feasible)” and blank for “unaware (e.g. I do not know if this solution is feasible)”. Total Priority score is the mean of the scores for each of the three criteria and is ranging from 0 to 100. Higher ranked solutions received more “Yes” responses for each of the criteria and a higher score)