Summary of previous evidence regarding the 2-week wait pathway for central nervous system tumours and malignancies
| Study | n | CNS tumours | CNS cancer | Guideline adherence | Other key findings |
|---|---|---|---|---|---|
| Pengiran-Tengah. (2003)11 | 43 | n/a | 9.3% | 69.2% | 69 patients diagnosed via other referral routes |
| Abernathy Holland (2008)12 | 13 | 0% | n/a | 7.7% | 6 CNS tumours outside 2WW pathway |
| Panicker (2012)13 | 70 | 11.4% | 7.1% | 17.2% | Newly diagnosed CNS tumour rate only 4.6%; remainder already known |
| Hamdan (2013)14 | 85 | 21.2% | n/a | 41.2% | Great yield associated with greater guideline adherence; most identified by non-urgent pathway |
| Webb (2015)15 | 105 | 9.5% | 6.7% | n/a | Seizures or subacute focal symptoms more likely to result in a significant neurological diagnosis |
| Ashton (2015)16 | 103 | 2.9% | n/a | 48.5% | Only 28% received imaging and an appointment within 2 weeks |
| Mohammad (2016)17 | 393 | n/a | 3.1% | n/a | CNS symptoms most predictive (PPV 4.1%), followed by progressive, subacute focal deficit or cognitive/behavioural/personality change (3.7%), then headaches with feature of raised ICP (1.2%) |
| Present study | 153 | 15.3% | 2.6% | n/a | n/a |
2WW = 2-week wait; CNS = central nervous system; ICP = intracranial pressure; PPV = positive predictive value.