Document Detail


The role of the doctor and the medical system in the diagnostic delay in pediatric malignancies.
MedLine Citation:
PMID:  20685192     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: We evaluated the roles of the doctor and the medical system in Israel in the diagnostic delay of childhood malignancies.
METHODS: We investigated the factors affecting the delay in the diagnosis of childhood malignancies in 315 children with solid malignancies, diagnosed and treated in Rambam Medical Center (RMC), between 1993 and 2001. Those factors were divided into two groups: 'Healthcare-system-related parameters', (factors directly related to the medical system), and 'Patient-related parameters' (factors that are not part of the medical system, but directly affect medical judgment and decisions, including factors related to the tumor). We also took into consideration epidemiological, social, and medical issues.
RESULTS: The main 'Healthcare-system-related parameters', which were found to influence the delay in diagnosis, were the type of medical authority that was initially consulted; the specialty of the first doctor; the number of additional doctors whom the child had visited, and the number of times the child had visited the first doctor. The main 'Patient-related parameters' found to have an impact on the delay in diagnosis were the age of the child, the tumor type, and the presenting symptom.
CONCLUSIONS: The education and awareness of doctors at the primary healthcare clinics must be improved. We suggest ways of improving the approach of doctors and managing a child with a suspected malignancy.
Authors:
Motti Haimi; Monique Perez-Nahum; Nili Stein; Myriam Weyl Ben Arush
Publication Detail:
Type:  Journal Article     Date:  2010-08-03
Journal Detail:
Title:  Cancer epidemiology     Volume:  35     ISSN:  1877-783X     ISO Abbreviation:  Cancer Epidemiol     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-18     Completed Date:  2011-05-31     Revised Date:  2011-06-17    
Medline Journal Info:
Nlm Unique ID:  101508793     Medline TA:  Cancer Epidemiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  83-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ltd. All rights reserved.
Affiliation:
Children's Health Center, Armon Tower, Clalit Health Services, Haifa, Israel. mottiha@clalit.org.il
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Delivery of Health Care*
Female
Humans
Infant
Male
Neoplasms / diagnosis*
Physician's Role*
Referral and Consultation*
Retrospective Studies
Risk Factors
Time Factors

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