Patient Adherence to Lung CT Screening Reporting & Data System-Recommended Screening Intervals in the United States: A Systematic Review and Meta-Analysis.
Patient Adherence to Lung CT Screening Reporting & Data System-Recommended Screening Intervals in the United States: A Systematic Review and Meta-Analysis.
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DOI：
10.1016/j.jtho.2021.09.013
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Prosper AE
中科院分区：
文献类型：
--
作者：
Lin Y;Fu M;Ding R;Inoue K;Jeon CY;Hsu W;Aberle DR;Prosper AE
肺癌筛查 (LCS) 可有效降低死亡率，特别是当患者遵守肺部 CT 筛查报告和数据系统 (Lung-RADS) 标准化的后续建议时。然而，患者对建议间隔的遵守情况各不相同，这可能会减少筛查的益处。我们对患者遵守 Lung-RADS 推荐筛查间隔的情况进行了系统回顾和荟萃分析。我们系统地检索了 2014 年 4 月 28 日至 2020 年 12 月 17 日期间的 MEDLINE、EMBASE、Web of Science、Cochrane 对照试验中央注册库以及主要放射学和肿瘤学会议档案。符合条件的研究提到患者遵守 Lung-RADS 的建议。该审查方案已在 PROSPERO 注册（CRD42020189326）。我们确定了 24 项符合条件的研究进行定性总结，其中 21 项适合进行荟萃分析。 6689 名患者中，对于明确的依从性（例如，在 15 个月内进行年度发病率筛查），汇总依从率为 57%（95% 置信区间：46%–69%）；对于 5085 名患者中的任何时间依从性，汇总依从率为 65%（95% 置信区间：55%–75%）。观察到研究之间的依从率存在很大异质性（对于规定的依从性，I2 = 99%，对于任何时间的依从性，I2 = 98%）。不同的依从率与 Lung-RADS 评分相关，Lung-RADS 3 至 4 的依从率显着高于 Lung-RADS 1 至 2 (p < 0.05)。在美国的临床 LCS 项目中，患者对 Lung-RADS 推荐筛查间隔的依从性并不理想，特别是在 Lung-RADS 结果为 1 至 2 类的患者中。为了提高依从率，未来的研究可能会侧重于在确定 LCS 障碍后实施量身定制的干预措施。我们还根据我们的研究结果提出了一套最低标准化数据元素，用于未来濒海战斗舰遵守情况的汇总分析。
Lung cancer screening (LCS) is effective in reducing mortality, particularly when patients adhere to follow-up recommendations standardized by the Lung CT Screening Reporting & Data System (Lung-RADS). Nevertheless, patient adherence to recommended intervals varies, potentially diminishing benefit from screening. We conducted a systematic review and meta-analysis of patient adherence to Lung-RADS–recommended screening intervals. We systematically searched MEDLINE, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, and major radiology and oncology conference archives between April 28, 2014, and December 17, 2020. Eligible studies mentioned patient adherence to the recommendations of Lung-RADS. The review protocol was registered with PROSPERO (CRD42020189326). We identified 24 eligible studies for qualitative summary, of which 21 were suitable for meta-analysis. The pooled adherence rate was 57% (95% confidence interval: 46%–69%) for defined adherence (e.g., an annual incidence screen was performed within 15 mo) among 6689 patients and 65% (95% confidence interval: 55%–75%) for anytime adherence among 5085 patients. Large heterogeneity in adherence rates between studies was observed (I2 = 99% for defined adherence, I2 = 98% for anytime adherence). Heterogeneous adherence rates were associated with Lung-RADS scores, with significantly higher adherence rates among Lung-RADS 3 to 4 than Lung-RADS 1 to 2 (p < 0.05). Patient adherence to Lung-RADS–recommended screening intervals is suboptimal across clinical LCS programs in the United States, especially among patients with results of Lung-RADS categories 1 to 2. To improve adherence rates, future research may focus on implementing tailored interventions after identifying barriers to LCS. We also propose a minimum standardized set of data elements for future pooled analyses of LCS adherence on the basis of our findings.
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影响因子：
39.2
作者：
Moyer, Virginia A.
通讯作者：
Moyer, Virginia A.
影响因子：
2.7
作者：
COCHRAN, WG
通讯作者：
COCHRAN, WG
影响因子：
5
作者：
Barbosa, Eduardo J. Mortani, Jr.;Yang, Rochelle;Hershman, Michelle
通讯作者：
Hershman, Michelle
DOI：
10.1016/j.jtcvs.2017.12.135
发表时间：
2018-06-01
影响因子：
6
作者：
Munoz-Largacha, Juan A.;Steiling, Katrina A.;Litle, Virginia R.
通讯作者：
Litle, Virginia R.
影响因子：
5
作者：
Guichet, Phillip L.;Liu, Beringia Y.;Lee, Christopher
通讯作者：
Lee, Christopher