title: Developing an early alert system for metastatic spinal cord compression (MSCC): Red Flag credit cards.
abstract: OBJECTIVE
  To produce a user-friendly list of metastatic spinal cord compression (MSCC) Red Flags for non-specialist 'generalist' front-line clinicians working in primary-care settings.
  
  
  BACKGROUND
  The issue of identifying MSCC early to prevent serious long-term disability was a key theme identified by the Task and Finish Group at Greater Manchester and Cheshire Cancer Network (GMCCN) in 2009. It was this group who initially brokered and then coordinated the current development as part of their strategic approach to improving care for MSCC patients.
  
  
  METHODS
  A consensus-building approach that considered the essential minimum data requirements to raise the index of suspicion suggestive of MSCC was adopted. This followed a model of cross-boundary working to facilitate the mutual sharing of expertise across a variety of relevant clinical specialisms.
  
  
  RESULTS
  A guideline aimed at helping clinicians to identify the early signs and symptoms of MSCC was produced in the form of a credit card. This credit card includes key statements about MSCC, signposting to key sources of additional information and a user-friendly list of Red Flags which has been developed into an eight-item Red Flag mnemonic. To date, an excess of 120,000 cards have been printed by a variety of organisations and the distribution of the cards is ongoing across the United Kingdom and the Republic of Ireland.
authors.affiliation: 1Lead for Rehabilitation and Survivorship,National Cancer Action Team,London,UK.
authors.forename: Jackie
authors.initials: J
authors.lastname: Turnpenney
authors.affiliation: 2Consultant Physiotherapist,Bolton NHS Foundation Trust,Royal Bolton Hospital,Bolton,UK.
authors.forename: Sue
authors.initials: S
authors.lastname: Greenhalgh
authors.affiliation: 3Clinical Specialist Physiotherapist,The Christie NHS Foundation Trust,Manchester,UK.
authors.forename: Lena
authors.initials: L
authors.lastname: Richards
authors.affiliation: 4Macmillan Occupational Therapist,Wigan & Leigh Hospice,Wigan,UK.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Crabtree
authors.affiliation: 5Professor of Physiotherapy,School of Sport,Tourism and The Outdoors,University of Central Lancashire,Preston,UK.
authors.forename: James
authors.initials: J
authors.lastname: Selfe
mesh_terms: D001296:Audiovisual Aids; D055088:Early Detection of Cancer / Q000379:methods*; D006801:Humans; D007494:Ireland; D013117:Spinal Cord Compression / Q000175:diagnosis* / Q000209:etiology*; D013125:Spinal Neoplasms / Q000150:complications* / Q000556:secondary*; D006113:United Kingdom