{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:04:17Z","timestamp":1773878657981,"version":"3.50.1"},"reference-count":68,"publisher":"Mark Allen Group","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Nurs"],"published-print":{"date-parts":[[2026,3,19]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Prompt diagnosis of aerodigestive cancers and other time-sensitive conditions improves survival and reduces morbidity and anxiety. However, early symptoms do not reliably differentiate between different pathologies and, in isolation, seldom localise the disease anatomically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To disseminate a multidisciplinary foregut (head and neck, oesophagogastric, and respiratory) diagnostic dataset, using patients\u2019 integrated clinical histories to initiate diagnostic pathways, reassure patients, and communicate information between stakeholders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      260 patients had their clinical histories taken either by two nurse specialists following training and then supported by a digital proforma (\n                      <jats:italic>n<\/jats:italic>\n                      =81), or by one laryngologist (\n                      <jats:italic>n<\/jats:italic>\n                      =179). The discriminative performance of the clinical history to ascertain specific symptoms was tested against validated Patient-Reported Outcome Measures (PROMs) using Receiver Operating Characteristic Area Under the Curve (ROC AUC) statistics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 103 men and 157 women. Mean age was 58\u00b116 years. All ROC AUCs were significantly greater than 0.5. For dysphagia, against the Eating Assessment Tool, AUC was 0.86\u00b10.02 [0.81-0.90]. For hoarseness, against the 10-item Voice Handicap Index, AUC was 0.82\u00b10.03 [0.77-0.0.86]. There were no significant differences in symptom ROCs between the laryngologist and trained nurse specialists using a digital proforma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The Integrated Foregut Clinical History implements the clinical history as diagnostic technology to guide clinical pathways. It performs well against validated PROMs and can form the basis of nurse-led pre-visit planning to support head and neck and upper gastrointestinal timed diagnostic pathways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.12968\/bjon.2025.0026","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T17:27:06Z","timestamp":1773854826000},"page":"328-337","source":"Crossref","is-referenced-by-count":0,"title":["The Integrated Foregut Clinical History: enabling nurse-led, joined-up initiation of suspected-cancer pathways"],"prefix":"10.12968","volume":"35","author":[{"given":"Robyn","family":"Parkes","sequence":"first","affiliation":[{"name":"Clinical Nurse Specialist"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"Probert","sequence":"additional","affiliation":[{"name":"Clinical Lead Speech and Language Therapist"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacey","family":"Baker","sequence":"additional","affiliation":[{"name":"Clinical Nurse Specialist"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Noon","sequence":"additional","affiliation":[{"name":"Clinical Nurse Specialist"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian M","family":"McGlashan","sequence":"additional","affiliation":[{"name":"Consultant Laryngologist"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony CR","family":"Simons","sequence":"additional","affiliation":[{"name":"Consultant Head &amp; Neck Surgical Oncologist"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon L","family":"Parsons","sequence":"additional","affiliation":[{"name":"Consultant Oesophago-Gastric Surgeon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacobo Ortiz","family":"Fernandez-Sordo","sequence":"additional","affiliation":[{"name":"Consultant Gastroenterologist"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J","family":"Martin","sequence":"additional","affiliation":[{"name":"Consultant Respiratory Physician At Nottingham University Hospitals NHS Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heetan","family":"Patel","sequence":"additional","affiliation":[{"name":"General Practitioner, Clifton Medical Practice, Nottingham"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SA Reza","family":"Nouraei","sequence":"additional","affiliation":[{"name":"Consultant Laryngologist, Nottingham University Hospitals NHS Trust, and Robert White Professor of Laryngology and Clinical Informatics, The Clinical Informatics Research Unit, University of Southampton"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5130","reference":[{"key":"e_1_3_3_1_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-016-2034-2"},{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14768"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.1986.hed2606285.x"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2024-332071"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940811701210"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0305-0483(99)00033-X"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605126"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13510"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/13558196241288068"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjon.2025.0053"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.2189-17.2017"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2020.1108"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001888-199706000-00016"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-022-07768-y"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1515\/dx-2021-0086"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2021.05.012"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-022-06588-9"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-022-06684-w"},{"key":"e_1_3_3_19_1","unstructured":"Darzi A; for Department of Health and Social Care. 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