News in brief: Six year wait for neurology appointments; MDT approach to genomic testing for drug-resistant epilepsy; Tough times for specialist college trainees

27 Jul 2022

Six year wait for neurology appointments

Some patients in South Australia are waiting up to six years for a neurology appointment in public hospitals, according to latest outpatient wait time report released by SA Health.

The figures show that for the reporting period up to 31 March 2022 the maximum waiting times for neurology appointments were 67 months at The Queen Elizabeth Hospital and 64 months at the Royal Adelaide Hospital, where appointments to see an epilepsy specialist were a maximum of 72 months.

Maximum wait times at other hospitals were 70 months at the Queen Elizabeth Hospital, 45 months at the Royal Adelaide Hospital and Lyell McEwin Hospital.

Median waiting times were 18 months at the Royal Adelaide Hospital for neurology appointments and 25 months for epilepsy appointments.

Waiting lists have improved since 2019 when the maximum waiting time was almost a decade (114 months) to see a neurologist at the RAH.

Chief medical officer Dr Michael Cusack said there had been several programs to reduce waiting lists for outpatient appointment, including asking GPs to audit all patients who have been waiting three years or longer in an effort to clear the backlog, a focus on alternative care pathways and putting patients back in GP care after an specialist consultation, rather than clogging the system with ongoing outpatient reviews.

There are also moves to develop centralised waiting lists to address variances in waiting times between hospitals, the Advertiser reports.

MDT approach best in genomic testing for drug-resistant epilepsy

A Multidisciplinary Team (MDT) approach is the way to integrate genomic testing for drug-resistant epilepsy into patient care, according to a University of Queensland study.

Neurologists and researchers assessed the diagnostic yield of genomic testing in 66 patients with drug-resistant epilepsy at three tertiary epilepsy centres. The pathway they used was an MDT approach involving adults and paediatric epilepsy specialists in patient selection, genomic testing choice, variant discussions and return of results.

The total diagnostic yield from cytogenomic testing and whole exome sequencing (WES) was 17% (11/66 patients), with four diagnoses from cytogenomic analyses, they reported in the Journal of Clinical Medicine.

All chromosomal microarray (CMA) diagnoses were in patients seen by adult neurologists. Diagnostic yield for WES was 11% (7/62 patients).

The most common gene with pathogenic variants was DCX, reported in three patients, of which two were mosaic. The genomic diagnosis impacted management in 82% (9/11 patients). Surveys of neurologists before and after the MDT approach showed there was increased confidence with integrating genomics into clinical care and their comments were highly supportive of the MDT approach.

Tough times for specialist college trainees

Advocacy for Specialist Medical College Trainees has been boosted via the AMA Council of Doctors in Training (CDT) Trainee Forums, according to the outgoing chair Dr Hash Abdeen.

In his final message the rheumatology trainee said the last two years has been a challenging time for trainees because of the impact of the pandemic on the healthcare system and exam disruptions.

Despite having to communicate and meet virtually for much of the time, he said a restructure of the council with 16 Specialist Medical College Trainee Committee Chairs & Representatives had helped to expand its advocacy.

The issue of trainee wellbeing had also been a priority for advocacy, addressed via the Wellbeing Specialist Interest Group, while the CDT had also contributed to progress in gender equity and flexible training policy.

Dr Abdeen said his successor as CDT Chair Dr Hannah Szewcyzk is an O&G trainee in South Australia and will do a great job over the next two years.


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