Purpose: To evaluate a patient for clinical findings that should result in an evaluation to exclude a cancer of the head and neck.			Citations with documentation. 27.01.03	Medal Project 2005. See disclaimer.
data	enter
Are you evaluating a patient with clinical findings affected the head and/or neck? (Y or N)		:-):-):-)
Does the patient have?
• an orbital mass? (Y or N)		:-):-):-)		0
• a neuropathy involving a cranial nerve? (Y or N)		:-):-):-)		0
• unexplained motility of a tooth (not due to periodontal disease or trauma)? (Y or N)		:-):-):-)		0
• a persistent nasal obstruction? (Y or N)		:-):-):-)		0
• a persistent red or reddish-white patch of the oral mucosa? (Y or N)		:-):-):-)		0
Duration of the following findings in weeks (enter 0 if absent)
• hoarseness		weeks		1
• ulceration of the oral mucosa		weeks		0
• an oral swelling or mass		weeks		0
• dysphagia		weeks		0
• an unresolved neck mass		weeks		0
calculate	result
data complete?	Yes
evaluation appropriate?	Yes	:-):-):-)
number of reasons to a referral to exclude a head or neck cancer	1	reasons for referral
Should the patient be evaluated to exclude a head or neck cancer?	probably	:-):-):-)