Variable radiological lung nodule evaluation leads to divergent management recommendations
| العنوان: | Variable radiological lung nodule evaluation leads to divergent management recommendations |
|---|---|
| المؤلفون: | Nair, A, Bartlett, EC, Walsh, SLF, Wells, AU, Navani, N, Hardavella, G, Bhalla, S, Calandriello, L, Devaraj, A, Goo, JM, Klein, JS, MacMahon, H, Schaefer-Prokop, CM, Seo, JB, Sverzellati, N, Desai, SR, Ahlfors, F, Bastos, A, Behr, J, Benes, J, Bozovic, G, Buzan, MT, Castaner, E, Chaves, M, Choi, YW, Dalpiaz, G, David, S, De Jong, PA, Dournes, G, Eberhard, M, Escuissato, D, Farchione, A, Flors, L, Franchi, P, Frauenfelder, T, Fujimoto, K, Gatti, M, Gavelli, G, Grgic, A, Haine, L, Haramati, L, Iiartman, T, Hartmann, I, Hering, JP, Herpels, V, Herraez, I, Hobbs, S, Hochhegger, B, Hursoy, N, Ip, J, Iyengar, S, Jimenez, JA, Johnson, K, Kanne, J, Kapur, S, Karaman, CZ, Karl, R, Kirova, G, Ko, J, Kramer, G, Kul, M, Larici, AR, Lee, Y, Leifels, L, Ley, S, Machnicki, S, Maidas, P, Mak, SM, Mariani, F, Meirelles, G, Hoesein, FAM, Montet, X, Murchison, J, Nath, H, Nenkina, T, Nganga, E, Linh, NKTD, Niemann, T, Nunez, CFM, Occhipiniti, M, Oikonomou, A, Ozawa, Y, Pandher, T, Parkar, AP, Piciucchi, S, Pinheiro, D, Poerio, A, Polverosi, R, Pope, K, Prosch, H, Pulzato, I, Rampinelli, C, Rodrigues, J, Romanos, O, Romei, C, Roos, J, Rossi, S, Ruhtsov, R, Ruggirello, M, Sanchez, M, Santos, MK, Schubert, M, Senbanjo, T, Silva, C, Silva, M, Snoeckx, A, Sonavane, S, Sriharan, M, Stefanidis, K, Taydas, O, Tomiyama, N, Tran, S, Villanueva, A, Williams, M, Lung Nodule Evaluation Grp |
| المصدر: | EUROPEAN RESPIRATORY JOURNAL r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante instname r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe |
| بيانات النشر: | EUROPEAN RESPIRATORY SOC JOURNALS LTD, 2018. |
| سنة النشر: | 2018 |
| الوصف: | Radiological evaluation of incidentally detected lung nodules on computed tomography (CT) influences management. We assessed international radiological variation in 1) pulmonary nodule characterisation; 2) hypothetical guideline-derived management; and 3) radiologists' management recommendations. 107 radiologists from 25 countries evaluated 69 CT-detected nodules, recording: 1) first-choice composition (solid, part-solid or ground-glass, with percentage confidence); 2) morphological features; 3) dimensions; 4) recommended management; and 5) decision-influencing factors. We modelled hypothetical management decisions on the 2005 and updated 2017 Fleischner Society, and both liberal and parsimonious interpretations of the British Thoracic Society 2015 guidelines. Overall agreement for first-choice nodule composition was good (Fleiss' kappa=0.65), but poorest for part-solid nodules (weighted 0.62, interquartile range 0.50-0.71). Morphological variables, including spiculation (kappa=0.35), showed poor-to-moderate agreement (kappa=0.23-0.53). Variation in diameter was greatest at key thresholds (5 mm and 6 mm). Agreement for radiologists' recommendations was poor (kappa=0.30); 21% disagreed with the majority. Although agreement within the four guideline-modelled management strategies was good (kappa=0.63-0.73), 5-10% of radiologists would disagree with majority decisions if they applied guidelines strictly. Agreement was lowest for part-solid nodules, while significant measurement variation exists at important size thresholds. These variations resulted in generally good agreement for guideline-modelled management, but poor agreement for radiologists' actual recommendations. |
| تدمد: | 0903-1936 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=dedup_wf_001::0e02d93e1884a4b018f807c703fcac21Test https://fundanet.isabial.san.gva.es/publicaciones/ProdCientif/PublicacionFrw.aspx?id=8034Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.dedup.wf.001..0e02d93e1884a4b018f807c703fcac21 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 09031936 |
|---|