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Multidisciplinary virtual management of pulmonary nodules

dc.contributor.authorPolanco, Dinora
dc.contributor.authorGonzález, Jessica
dc.contributor.authorGracia-Lavedan, Esther
dc.contributor.authorPinilla, Lucía
dc.contributor.authorPlana, R.
dc.contributor.authorMolina, M.
dc.contributor.authorPardina Solano, Marina Asunción
dc.contributor.authorBarbé Illa, Ferran
dc.date.accessioned2022-05-10T11:13:13Z
dc.date.available2022-05-10T11:13:13Z
dc.date.issued2022
dc.identifier.issn2531-0437
dc.identifier.urihttp://hdl.handle.net/10459.1/83253
dc.description.abstractIntroduction and objectives: Multidisciplinary nodule clinics provide high-quality care and favor adherence to guidelines. Virtual care has shown savings benefits along with patient satisfaction. Our aim is to describe the first year of operation of a multidisciplinary virtual lung nodule clinic, the population evaluated and issued decisions. Secondarily, among discharged patients, we aimed to analyze their follow-up prior to the existence of our consultation, evaluating its adherence to guidelines. Materials and methods: Observational study including all patients evaluated at the Virtual Lung Nodule Clinic (VLNC) (March 2018- March 2019). Clinical and radiological data were recorded. Recommendations, based on 2017 Fleischner Society guidelines, were categorized into follow-up, discharge or referral to lung cancer consultation. Discharged patients were classified according to adherence to guidelines of their previous management, into adequate, prolonged and non-indicated follow-up. Results: A total of 365 patients (58.9% men; median age 64.0 years) were included. Sixty-four percent had smoking history and 23% had chronic obstructive pulmonary disease (COPD). Most nodules were solid (87.4%) and multiple (57.5%). The median diameter was 6.00 mm. 43.8% of patients were discharged following first VLNC evaluation. Among them, 27.5% had received appropriate follow-up, but 66.9% had received poor management. Patients with prolonged follow-up (33.1%) were older (67.0 vs 60.5 years) and had larger nodules (6.00 mm vs 5.00). Non-indicated follow-up patients (33.8%) were more non-smokers (77.8% vs 31.8%) and presented smaller nodules (4.00 vs 5.00 mm). Conclusions: During its first year of operation, the VLNC has evaluated a population with a relevant risk profile for lung cancer development, management of which should be cautious and adhere to guidelines. After the first VLNC assessment, approximately one-half of this population was discharged. It was noticeable that previous follow-up of discharged patients was found poorly adherent to guidelines, with a marked tendency to overmanagement.ca_ES
dc.language.isoengca_ES
dc.publisherElsevierca_ES
dc.publisherSociedade Portuguesa de Pneumologiaca_ES
dc.relation.isformatofReproducció del document publicat a: https://doi.org/10.1016/j.pulmoe.2021.12.003ca_ES
dc.relation.ispartofPulmonology, 2022, in pressca_ES
dc.rightscc-by-nc-nd (c) Sociedade Portuguesa de Pneumologia, 2022ca_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectLung cancerca_ES
dc.subjectLung noduleca_ES
dc.subjectMultidisciplinary careca_ES
dc.subjectPulmonary nodulesca_ES
dc.subjectRemote careca_ES
dc.subjectVirtual careca_ES
dc.titleMultidisciplinary virtual management of pulmonary nodulesca_ES
dc.typeinfo:eu-repo/semantics/articleca_ES
dc.identifier.idgrec032251
dc.type.versioninfo:eu-repo/semantics/publishedVersionca_ES
dc.rights.accessRightsinfo:eu-repo/semantics/openAccessca_ES
dc.identifier.doihttps://doi.org/10.1016/j.pulmoe.2021.12.003


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cc-by-nc-nd (c) Sociedade Portuguesa de Pneumologia, 2022
Except where otherwise noted, this item's license is described as cc-by-nc-nd (c) Sociedade Portuguesa de Pneumologia, 2022