The computer application «SCAE» in the early diagnosis of musculoskeletal cancer in the healthcare area of the Hospital Universitario 12 de Octubre. Analysis of its effectiveness and proposals for improvement.

Abstract

INTRODUCTION\nThe SCAE-SM (Request for an Appointment in Specialized Care-Suspicion of Malignancy) computer application is a tool available to Primary Care (PC) physicians for the referral of patients who should be evaluated by the specialist in a maximum period of 2 weeks when malignancy is suspected. The objective of our work was to analyze the usefulness of this tool and propose areas for improvement in the management of patients with suspected musculoskeletal malignancy.\n\n\nMATERIAL AND METHODS\nA descriptive cross-sectional study of 235 referrals received in the years 2012-2017 was carried out. Their origin, the information contained in the applications and the response provided by historical evaluators, without specific oncology training, were analyzed. For this study, a new blind assessment of all applications was carried out by 13 orthopedists with different levels of specific training in musculoskeletal oncology (re-evaluators).\n\n\nRESULTS\nAmong all SCAE-SM, only 8.23% of patients had aggressive benign or malignant disease. The most successful re-evaluators in the adequacy of early appointment were those with moderate oncological training (5-10 years of experience). During the study, of all the patients treated in the Tumor Unit, only 18.81% accessed through the SCAE-SM circuit, with a mean waiting time of 18.11 days from the PC referral.\n\n\nCONCLUSIONS\nThe SCAE-SM computer application as tool for improve the management and advance care for patients with malignant musculoskeletal tumor pathology is useful, although the use of the circuit is inadequate. It is necessary to disseminate and generalize it, as well as to implement basic oncology training programs both in the field of PC and Hospital.