Dataset Information

Argentine consensus recommendations for lung cancer screening programmes: a RAND/UCLA-modified Delphi study.

ABSTRACT:

Background

Lung cancer (LC) screening improves LC survival; the best screening method in terms of improving survival is low-dose CT (LDCT), outpacing chest X-ray and sputum cytology.

Methods

A consensus of experts in Argentina was carried out to review the literature and generate recommendations for LC screening programmes. A mixed-method study was used with three phases: (1) review of the literature; (2) modified Delphi consensus panel; and (3) development of the recommendations. The Evidence to Decision (EtD) framework was used to generate 13 evaluation criteria. Nineteen experts participated in four voting rounds. Consensus among participants was defined using the RAND/UCLA method.

Results

A total of 16 recommendations scored ≥7 points with no disagreement on any criteria. Screening for LC should be performed with LDCT annually in the population at high-risk, aged between 55 and 74 years, regardless of sex, without comorbidities with a risk of death higher than the risk of death from LC, smoking ≥30 pack-years or former smokers who quit smoking within 15 years. Screening will be considered positive when finding a solid nodule ≥6 mm in diameter (or ≥113 mm³) on baseline LDCT and 4 mm in diameter if a new nodule is identified on annual screening. A smoking cessation programme should be offered, and cardiovascular risk assessment should be performed. Institutions should have a multidisciplinary committee, have protocols for the management of symptomatic patients not included in the programme and distribute educational material.

Conclusion

The recommendations provide a basis for minimum requirements from which local institutions can develop their own protocols adapted to their needs and resources.

SUBMITTER: Boyeras I

PROVIDER: S-EPMC9900059 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

Argentine consensus recommendations for lung cancer screening programmes: a RAND/UCLA-modified Delphi study.

Boyeras Iris I Roberti Javier J Seijo Mariana M Suárez Verónica V Morero José Luis JL Patané Ana Karina AK Kaen Diego D Lamot Sebastián S Castro Mónica M Re Ricardo R García Artemio A Vujacich Patricia P Videla Alejandro A Recondo Gonzalo G Fernández-Pazos Alfonso A Lyons Gustavo G Paladini Hugo H Benítez Sergio S Martín Claudio C Defranchi Sebastián S Paganini Lisandro L Quadrelli Silvia S Rossini Sebastián S Garcia Elorrio Ezequiel E Sobrino Edgardo E

BMJ open 20230203 2

<h4>Background</h4>Lung cancer (LC) screening improves LC survival; the best screening method in terms of improving survival is low-dose CT (LDCT), outpacing chest X-ray and sputum cytology.<h4>Methods</h4>A consensus of experts in Argentina was carried out to review the literature and generate recommendations for LC screening programmes. A mixed-method study was used with three phases: (1) review of the literature; (2) modified Delphi consensus panel; and (3) development of the recommendations. ...[more]

PMID: 36737082

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Project description:IntroductionOntario ambulances are restricted from patient transportation to sub-acute levels of care when these facilities may be more suitable than emergency departments for non-emergent conditions. There is no known patient classification specifically constructed to inform ED diversion protocols and guidance for sub-acute centre transportation for primary care-like patient conditions.ObjectiveTo construct a novel patient classification of potentially preventable emergency department visits following transport by ambulance, and analyse patient-level characteristic associations with this classification based in Ontario secondary data.Methods and analysisThe Primary Care-like Ambulance transports following Response for 911-Emergencies (PriCARE) patient classification will be constructed using a two-phase RAND/UCLA modified Delphi design. All experts included are physicians with relevant experience in emergency and/or primary care in Ontario. The first phase of the study will determine consensus of the expert committee on which ED interventions performed on patients with non-emergent acuities could be conducted in sub-acute healthcare centres. The second phase will assess consensus of which patient, hospital and acuity factors are most appropriate to be incorporated into a PriCARE classification. We will also investigate secondary outcomes on consensus of which ED interventions could be transferred to a paramedic context given an expanded scope of practice and patient-level characteristics of PriCARE classified individuals.Ethics and disseminationThis study received a research ethics board exemption waiver from the Hamilton Integrated Research Ethics Board; review reference 2020-11451-GRA. Results will be submitted for publication in a peer-reviewed journal and presented at relevant conferences. The results will be shared with Ontario paramedic services and governing institutions. This study will be used to inform patient classification protocols and clinical decision tools for ambulances to transport to sub-acute healthcare centres.Trial registration numberISRCTN22901977.

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Dataset Information

Argentine consensus recommendations for lung cancer screening programmes: a RAND/UCLA-modified Delphi study.

Background

Methods

Results

Conclusion

Publications

Argentine consensus recommendations for lung cancer screening programmes: a RAND/UCLA-modified Delphi study.

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