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Introduction The COVID-19 pandemic has disrupted many aspects of clinical practice in oncology, particularly regarding early cancer diagnosis, sparking public health concerns that possible delays could increase the proportion of patients diagnosed at advanced stages. In 2009, a cancer fast-track program (CFP) was implemented at the Clinico-Malvarrosa Health Department in Valencia, Spain with the aim of shortening waiting times between suspected cancer symptoms, diagnosis and therapy initiation. Objectives The study aimed to explore the effects of the COVID-19 pandemic on our cancer diagnosis fast-track program. Methods The program workflow (patients included and time periods) was analysed from the beginning of the state of alarm on March 16th, 2020 until March 15th, 2021. Data was compared with data from the same period of time from the year before (2019). Results During the pandemic year, 975 suspected cancer cases were submitted to the CFP. The number of submissions only decreased during times of highest COVID-19 incidence and stricter lockdown, and overall, referrals were slightly higher than in the previous 2 years. Cancer diagnosis was confirmed in 197 (24.1%) cases, among which 33% were urological, 23% breast, 16% gastrointestinal and 9% lung cancer. The median time from referral to specialist appointment was 13 days and diagnosis was reached at a median of 18 days. In confirmed cancer cases, treatment was started at around 30 days from time of diagnosis. In total, 61% of cancer disease was detected at early stage, 20% at locally advanced stage, and 19% at advanced stage, displaying time frames and case proportions similar to pre-pandemic years. Conclusions Our program has been able to maintain normal flow and efficacy despite the challenges of the current pandemic, and has proven a reliable tool to help primary care physicians referring suspected cancer patients.

Background: Today, while there are effective drugs that reduce the risk of osteoporotic fracture, yet there are no broadly accepted criteria that can be used to estimate risks and decide who should receive treatment. One of the actual priorities of clinical research is to develop a set of simple and readily-available clinical data that can be used in routine clinical practice to identify patients at high risk of bone fracture, and to establish thresholds for therapeutic interventions. Such a tool would have high impact on healthcare policies. The main objective of the ESOSVAL-R is to develop a risk prediction scale of osteoporotic fracture in adult population using data from the Region of Valencia, Spain., Study Design: An observational, longitudinal, prospective cohort study, undertaken in the Region of Valencia, with an initial follow-up period of five years;, Subjects: 14,500 men and women over the age of 50, residing in the Region and receiving healthcare from centers where the ABUCASIS electronic clinical records system is implanted;, Sources of Data: The ABUCASIS electronic clinical record system, complemented with hospital morbidity registers, hospital Accidents & Emergency records and the Regional Ministry of Health's mortality register; Measurement of results: Incident osteoporotic fracture (in the hip and/or major osteoporotic fracture) during the study's follow-up period. Independent variables include clinical data and complementary examinations;, Analysis: 1) Descriptive analysis of the cohorts' baseline data; 2) Upon completion of the follow-up period, analysis of the strength of association between the risk factors and the incidence of osteoporotic fracture using Cox's proportional hazards model; 3) Development and validation of a model to predict risk of osteoporotic fracture; the validated model will serve to develop a simplified scale that can be used during routine clinical visits., Discussion: The ESOSVAL-R study will establish a prediction scale for osteoporotic fracture in Spanish adult population. This scale not only will constitute a useful prognostic tool, but also it will allow identifying intervention thresholds to support treatment decision-making in the Valencia setting, based mainly on the information registered in the electronic clinical records.

Objective: To evaluate a primary care protocol for intensive monitoring of cardiovascular risk (CVR) factors in type-2 diabetes patients versus usual care., Design: Randomised trial with clusters., Setting: Primary care clinics., Participants: Sixty family physicians., Interventions: Participants were randomised between following a protocol of intensive monitoring of CVR factors and maintaining their habitual practice with DM2 patients. Follow-up lasted 12 months. Data on HbA1C, CVR factors and CVR were collected at the start of the study and at 12 months., Results: In all, 188 patients (94 intervention group and 94 control group) were included. At baseline measurement, CVR in control group (CG) was 36.3% (95% CI, 33.9%-38.6%); and in intervention group (IG), 35.9% (95% CI, 33.5%-38.4%), with no significant differences between groups. At one year, CVR in CG was 33.1% (95% CI, 30%-36.1%) and in IG 30.5% (95% CI, 27.8%-33.2%). The CVR difference between baseline and 1-year measurements was 2.9% (95% CI, 0.2%-5.7%) in CG and 5.4% (95% CI, 2.8%-7.1%) in IG., Conclusions: Although improvement of CVR is greater in the IG, the difference between the two groups is not significant. The characteristics of the doctors chosen may have meant that the patients of the two groups received similar treatment.

Objective: To determine as accurately as possible the incidence of pulmonary tuberculosis within Health Area 15 of the Community of Valencia during the period 1990-1993, using the capture-recapture method., Method: Descriptive study on the population of Health Area 15 (population: -139.903) divided into 4 large groups according to age (0-14, 15-34, 34-54 and 55+). Data was obtained from the statutory notification system of infectious disease (SNSID) and from the registry of the said area's Hospital Microbiology SERVICE: The main variable under study was the number of cases of pulmonary tuberculosis, both as notified under the SNSID and in terms of cases in the microbiology register in which M. tuberculosis was isolated. The incidence-rates were calculated by age and year of study for both registries employing the capture-recapture method., Results: The mean annual incidence obtained for the SNSID register during the study period was 15.85 cases x 10(-5), and for the microbiology registry it was 23.29 x 10(-5). When the capture-recapture method was employed the mean annual incidence for the study period was 34.81 x 10(-5) (CI 95%: 31.82-39.92). In each of the years studied the number of cases identified was greater for the microbiology register than for the SNSID. Around half the cases of tuberculosis are below 34 years of age, with the larger section, and that having the highest incidence of tuberculosis being the 15 to 34 years age-group. There is no apparent upward trend in incidence rates calculated for this period., Conclusions: The data from the SNSID system on incidence of pulmonary tuberculosis within Health Area 15 of the Community of Valencia tends to underestimate the true incidence rate. The factual resources of the Hospital Microbiology Service are underutilized, considering the quantity and quality of information it can provide. The capture-recapture method is a good choice of method for measuring tuberculosis incidence. This method merits greater use within the field of epidemiology as much in order to assess the representativeness and thoroughness of surveillance systems as to identify inadequacies in their reporting and localisation of disease outbreaks.