Management of SPN in France. Pathways for definitive diagnosis of solitary pulmonary nodule: a multicentre study in 18 French districts.

BMC Cancer
Kazem AlzahouriFrancis Guillemin

Abstract

The process of diagnosis and management of solitary pulmonary nodules (SPNs) between 1 and 3 cm is not standardized. This multicentre study investigated how diagnosis of newly discovered SPNs is managed in routine practice. We examined 11,515 radiology reports of patients undergoing chest computed tomography (CT) at all 76 radiology centres in 18 French administrative districts covering 8,220,000 people. Information on diagnostic procedures and treatment administered from discovery to definitive diagnosis of SPN was collected prospectively. We identified 152 cases of newly diagnosed SPNs. Follow-up was complete for 112 patients. The median number of diagnostic tests was 4 and the mean time to diagnosis was 41.4 days. Marked variability was observed in the sequence of diagnostic tests, and 8 diagnostic pathways were identified. Patients' characteristics and radiological features of SPNs influenced the number of tests performed. Referral by specialist, history of smoking and spiculated SPN predicted the performance of at least one invasive procedure (P < 0.01). Definitive diagnosis was a malignant disease in 30 patients (26%). The diagnosis of SPN is a complex process that physicians approach in markedly different ways. Implement...Continue Reading

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Citations

Aug 10, 2010·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Irawati LemonnierFrancis Guillemin
Jun 3, 2014·Health and Quality of Life Outcomes·Irawati LemonnierCédric Baumann
Jul 30, 2015·Journal of Cardiothoracic Surgery·Young Jo SaSeok Whan Moon
Mar 1, 2016·Journal of the American College of Radiology : JACR·Sanja Percac-LimaSteven J Atlas
Apr 6, 2021·Journal of Health Organization and Management·Syaribah Noor BriceKieran Foley

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Methods Mentioned

BETA
biopsy
surgical resection

Software Mentioned

Statistical Analysis System

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