Persistent Unilateral Sore Throat: Should It Be Included in the 2-Week Wait Referral Criteria by NICE

Ahmed Allam; Hazem Nijim

doi:10.1155/2019/4920514

Persistent Unilateral Sore Throat: Should It Be Included in the 2-Week Wait Referral Criteria by NICE

Int J Otolaryngol. 2019 May 5:2019:4920514. doi: 10.1155/2019/4920514. eCollection 2019.

Authors

Ahmed Allam^{1

2}, Hazem Nijim³

Affiliations

¹ Otolaryngology Department, Sheffield Teaching Hospitals NHS Trust, UK.
² Department of Otolaryngology, Faculty of Medicine, Mansoura University, Egypt.
³ Otolaryngology Department, Derby Teaching Hospitals, UK.

Abstract

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.