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Outside the Lab Regulation and standards, Quality assurance and quality control

Under Interrogation

In 2021, community diagnostic centers were launched by the NHS to increase diagnostic capacity – a national imperative exacerbated by the onslaught of the COVID-19 pandemic. The primary aim? To improve population health outcomes by diagnosing health conditions faster and more accurately – thus alleviating some of the pressure faced by hospitals. To assess their effectiveness, Public Health Wales (as part of the Wales COVID-19 Evidence Center Work Programme rapid review) conducted a rapid review that analyzed existing evidence on the efficiency of community diagnostic centers.

Only comparative studies examining community diagnostic centers that accepted referrals from primary care as a minimum were included in the study, which allowed a total of 20 studies published between 1998 and 2021 to be chosen for evaluation (11 conducted in Spain, five conducted in the UK, and four conducted in Canada). Overall, 12 individual diagnostic centers were evaluated across the 20 studies, with the majority of these studies specific to cancer diagnoses.

According to the review, there is evidence to suggest that some waiting times (for example, time to surgical consultation and time from cancer suspicion to treatment) were reduced. Although evidence for other waiting times – namely, diagnostic examination and time to diagnosis – was mixed. The reviewers also considered the impact of diagnostic centers in alleviating pressure on secondary healthcare. Here, some evidence suggested that the number of visits needed to receive a definite diagnosis and the number of stable patients being referred for hospitalization overtime were reduced; however, these outcomes were concluded by individual studies rather than an overall consensus. 

The review also considered cost effectiveness, which was found to be reliant on centers running at full capacity; some studies did report that diagnostic center performance seemed to be more cost-effective than traditional inpatient care. 

Overall then, the rapid review revealed mixed results. Though the authors did note that the results may not be generalizable because data was taken from studies outside of the UK and from different healthcare systems. More research is needed, they said, before drawing a firm conclusion on the effectiveness of community diagnostic centers.

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  1. A Wale et al., “What is the effectiveness of community diagnostic centers: a rapid review,” [Preprint] (2022).
About the Author
Georgia Hulme

Associate Editor for the Pathologist

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