A rapid evidence map of what evidence is available on the effectiveness of community diagnostic centres

Abstract

AbstractThe COVID-19 pandemic has resulted in increased demand and delays to diagnostic services. Community diagnostic centres (which are generally referred to as Regional Diagnostic Hubs in Wales) aim to reduce this backlog and the waiting times for patients by providing a broad range of elective diagnostic services in the community, away from acute hospital facilities. As diagnostic services account for over 85% of clinical pathways and cost the National Health Service (NHS) over six billion pounds a year (NHS 2022), community diagnostic centres across a broader range of diagnostic services may be an effective, efficient, and cost-effective introduction to the UK health sector. This Rapid Evidence Map aimed to identify, describe, and map the available evidence on the effectiveness of diagnostic centres. 50 primary studies were identified. Studies were published between 1995 and 2021: A wide range of study designs were used, and studies were conducted in a range of countries including the UK. 30 studies were specific to cancer diagnosis, whilst the remaining 20 studies focused on diagnosis associated with: anaemia, autism, cerebral palsy, intellectual disability, multiple sclerosis, respiratory conditions, shoulder pain, and unexplained fever Eleven studies reported information on multi-condition diagnostic centres, rather than a specific condition.The majority of studies were conducted within hospital settings. Two studies evaluated diagnostic centres within a community setting. The diagnostic centres offered a wide range of diagnostic tests and incorporated different staff and facilities. Participants were mainly referred by GPs, primary care centres and emergency departments. However, referrals were also made from outpatient clinics located within the same hospital as the diagnostic centre.Over 100 different outcomes were reported covering: patient data and referral outcomes, clinical outcomes, performance outcomes, economic outcomes, and patient and physician-reported outcomes.The findings of this rapid evidence map were used to select a substantive focus for a subsequent rapid review on community diagnostic centres that can be accessed by primary care teams.