Guidelines for the Evaluation of Pulmonary Nodules Detected Incidentally or by Screening: A Survey of Radiologist Awareness,Agreement, and Adherence From the Watch the Spot Trial |
| |
| Institution: | 1. Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California;2. Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California;3. Center for Healthy Living, Kaiser Permanente Southern California, Pasadena, California;4. Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, California;5. VA Portland Healthcare System, Portland, Orgeon;6. Department of Medicine, University of California, San Francisco, California;7. Department of Medicine, School of Medicine, University of California, Davis, Davis, California;8. Kaiser Permanente Washington Health Research Institute, Seattle, Washington;9. Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon;10. Department of Radiology and Biomedical Imaging, Department of Epidemiology and Biostatistics, and Phillip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California;11. Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;12. Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts;13. The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts;14. Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, California;15. Department of Radiology, National Jewish Health, Denver, Colorado;1. Vice Chair Quality, Department of Radiology & Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia;2. Vice Chair of Clinical Affairs, Department of Radiology & Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia;3. Department of Radiology & Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia;4. Chair of Department of Radiology and Imaging Sciences, Department of Radiology & Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia;1. senior employee at Amazon.com, Seattle, Washington;2. Johns Hopkins Medicine, Department of Radiology and Radiological Science, Department of Oncology and Department of Surgery. He serves as Director of Diagnostic Imaging and Body CT at Johns Hopkins University School of Medicine, Baltimore, Maryland;3. Associate Professor, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland;1. Department of Radiology, New York-Presbyterian/Weill Cornell Medical Center, New York, New York;2. Director of Radiology, Denver Health, Denver, Colorado;3. Vice Chair, Department of Radiology, University of Colorado, Denver, Colorado;1. Marriott International, Bethesda, Maryland;2. The Russell H. Morgan Department of Radiology and Radiological Science, Department of Oncology, and Department of Surgery. He serves as Director of Diagnostic Imaging and Body CT at Johns Hopkins University School of Medicine, Baltimore, Maryland;3. The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland;1. Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts;2. Harvard Medical School, Boston, Massachusetts;3. National Jewish Health, Denver, Colorado |
| |
| Abstract: | PurposeThe aim of this study was to examine radiologists’ beliefs about existing guidelines for pulmonary nodule evaluation.MethodsA self-administered survey was developed to ascertain awareness of, agreement with, and adherence to published guidelines, including those from the Fleischner Society and the Lung CT Screening Reporting and Data System (Lung-RADS™). Surveys were distributed to 514 radiologists at 13 health care systems that are participating in a large, pragmatic trial of pulmonary nodule evaluation. Prespecified comparisons were made among groups defined by type of health system, years of experience, reader volume, and study arm.ResultsThe response rate was 26.3%. Respondents were most familiar with guidelines from Fleischner (94%) and Lung-RADS (71%). For both incidental and screening-detected nodules, self-reported adherence to preferred guidelines was very high (97% and 94%, respectively), and most respondents believed that the benefits of adherence outweigh the harms (81% and 74%, respectively). Underlying evidence was thought to be high in quality by 68% of respondents for screening-detected nodules and 41% for incidental nodules. Approximately 70% of respondents believed that the frequency of recommended follow-up was “just right” for both guidelines. Radiologists who practice in nonintegrated health care systems were more likely to believe that the evidence was high in quality (79.5% versus 57.1%) and that the benefits of adherence outweigh the harms (85.1% versus 67.5%). Low-volume readers had lower awareness and self-reported adherence than higher volume readers.ConclusionsRadiologists reported high levels of familiarity and agreement with and adherence to guidelines for pulmonary nodule evaluation, but many overestimated the quality of evidence in support of the recommendations. |
| |
| Keywords: | Pulmonary nodule clinical practice guidelines radiology practice adherence survey methods |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
