Real-world Clinical Implementation of Lung Cancer Screening-Evaluating Processes to Improve Screening Guidelines-Concordance
Real-world Clinical Implementation of Lung Cancer Screening-Evaluating Processes to Improve Screening Guidelines-Concordance
复制标题
DOI：
10.1007/s11606-019-05539-w
复制
发表时间：
2020-04-01
影响因子：
5.7
通讯作者：
Ritzwoller, Debra P.
中科院分区：
文献类型：
--
作者：
Carroll, Nikki M.;Burnett-Hartman, Andrea N.;Ritzwoller, Debra P.
肺癌筛查（LCS）需要复杂的过程来确定符合条件的患者，提供适当的随访，并管理结果。目前尚不清楚LCS在实际临床环境中是否能实现与国家肺筛查试验（NLST）相同的益处。目的评价LCS项目实施过程中工艺修改对LCS指南依从性的影响，并将患者特征和结果与NLST进行比较。设计回顾性队列研究。设置凯撒永久科罗拉多州（KPCO），一个非营利性的综合医疗保健系统。2014年5月至2017年6月期间，共有3375名患者接受了基线肺癌筛查低剂量计算机断层扫描（S-LDCT）扫描。在接受S-LDCT的患者中，在LCS过程修改前后符合基于指南的LCS资格标准的比例，KPCO LCS患者与NLST队列之间患者特征和结果的差异，以及与阳性筛查相关的因素。结果在修改LCS资格确认程序后，接受S-LDCT的患者符合基于指南的LCS资格标准的患者从45.6%增加到92.7% (P
BackgroundLung cancer screening (LCS) requires complex processes to identify eligible patients, provide appropriate follow-up, and manage findings. It is unclear whether LCS in real-world clinical settings will realize the same benefits as the National Lung Screening Trial (NLST).ObjectiveTo evaluate the impact of process modifications on compliance with LCS guidelines during LCS program implementation, and to compare patient characteristics and outcomes with those in NLST.DesignRetrospective cohort study.SettingKaiser Permanente Colorado (KPCO), a non-profit integrated healthcare system.PatientsA total of 3375 patients who underwent a baseline lung cancer screening low-dose computed tomography (S-LDCT) scan between May 2014 and June 2017.MeasurementsAmong those receiving an S-LDCT, proportion who met guidelines-based LCS eligibility criteria before and after LCS process modifications, differences in patient characteristics and outcomes between KPCO LCS patients and the NLST cohort, and factors associated with a positive screen.ResultsAfter modifying LCS eligibility confirmation processes, patients receiving S-LDCT who met guidelines-based LCS eligibility criteria increased from 45.6 to 92.7% (P