Impact of rapid investigation clinic on timeliness of lung cancer diagnosis and treatment
| Autor: | L. Ofiara, Kevin Schwartzman, Anne V. Gonzalez, Nicole Ezer, Asma Navasakulpong |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Multivariate analysis Delayed Diagnosis Lung Neoplasms Time Factors Lung cancer diagnosis Mediastinoscopy Endosonography Time-to-Treatment 03 medical and health sciences 0302 clinical medicine Bronchoscopy Interquartile range Internal medicine hemic and lymphatic diseases Carcinoma Non-Small-Cell Lung medicine Humans Lung cancer Referral and Consultation Aged Neoplasm Staging Quality of Health Care lcsh:RC705-779 Delay medicine.diagnostic_test business.industry Confounding Biopsy Needle Timeliness lcsh:Diseases of the respiratory system Middle Aged medicine.disease Small Cell Lung Carcinoma Confidence interval Pulmonologists 030228 respiratory system 030220 oncology & carcinogenesis Multivariate Analysis Female Lung cancer staging business Nurse Clinicians Delivery of Health Care Research Article |
| Zdroj: | BMC Pulmonary Medicine BMC Pulmonary Medicine, Vol 17, Iss 1, Pp 1-8 (2017) |
| ISSN: | 1471-2466 |
| Popis: | Background Guidelines recommend timely evaluation of patients with suspected lung cancer. We evaluated the impact of a Rapid Investigation Clinic (RIC) on timeliness of lung cancer diagnosis and treatment between February 2010 and December 2011. Methods Investigation within the RIC was conducted by a pulmonologist and a nurse clinician. Controls were patients with lung cancer, investigated outside the RIC at the same institution during the same time period. The primary outcome was time between first contact with a local physician for suspected lung cancer (T0) and first treatment. Factors associated with the delay from T0 to first treatment were examined using multivariate analysis. Completeness of lung cancer staging according to guidelines was assessed. Results A total of 195 patients were investigated within the RIC vs. 132 patients outside the RIC. The median delay between T0 and first treatment was 65 days (interquartile range [IQR] 46–92 days) in the RIC and 78 days (IQR 49–119 days) in the non-RIC patients (p ≤ 0.01). Time from T0 to pathological diagnosis was shorter in the RIC (median 26 days; IQR 14–42 days) vs. non-RIC patients (median 40 days; IQR 16–68 days). In multivariate analysis, investigation in the RIC was associated with a reduction in time to first treatment of 24 days (95% confidence interval [CI] 12–35 days) when adjusted for relevant confounders. Guideline-concordant investigation occurred more frequently in RIC patients, based on the quality indicators examined. Conclusions A Rapid Investigation Clinic reduces delays to lung cancer diagnosis and treatment, and impacts quality of care. |
| Databáze: | OpenAIRE |
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