Our finding of a median reduction of 10 days may not result in reduced mortality in general, but the patients who waited the longest (e.g. the 75 percentile was 74 days at other hospitals than Vejle before the national introduction of the urgent referral guidelines) may have gained more from the introduction of the urgent referral guidelines.
However, the questionnaire was based on the NICE urgent referral guidelines for suspected CRC, and its robustness as a data collection tool was established during pilot work.
This finding indicates that the shorter secondary care intervals not only result from the urgent referral guidelines, but also involve other factors.
Therefore, it is urgent that guidelines for conducting ex situ conservation and promoting the propagation of individuals for the next generation are put in place.
The tendency towards a decrease in the secondary care interval at other hospitals seemed to appear when the need for such decrease was officially recognised, i.e. before the formal implementation of the urgent referral guidelines.
This bias may therefore lead us to make a type II error by underestimating the association between the introduction of the urgent referral guidelines and the secondary care interval.
Both before and after the national introduction of the urgent referral guidelines, patients had a shorter secondary care interval in cases where initial symptoms were categorised as alarm symptoms by the GP or the GP indicated cancer suspicion in the referral documents.
In the case of AMI, in contrast, not only is treatment urgent, but guideline compliant care varies significantly across patients.
The NSPCC is calling for an urgent overhaul of guidelines issued to social workers which it says encourage them to adopt an approach "of waiting for neglect to persist" before intervening.
However, little information is available about its ecological, evolutionary and genetic status, despite the urgent need for guidelines for the conservation of the species.
