The economic impact of a nurse practitioner–directed lung cancer screening, incidental pulmonary nodule, and tobacco-cessation clinic

Gilbert, Christopher R.; Ely, Rob; Fathi, Joelle T.; Louie, Brian E.; Wilshire, Candice L.; Modin, Hannah E.; Aye, Ralph W.; Farivar, Alexander S.; Vallières, Eric; Gorden, Jed A.

doi:10.1016/j.jtcvs.2017.07.086

Cited by 22 publications

(14 citation statements)

References 24 publications

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“…Most of those interventions were minimally invasive ENB-guided and EBUS-guided bronchoscopy procedures. Although we did not conduct a formal cost-effectiveness analysis, our results support prior publications from Europe [32], the United Kingdom [33], Asia [34], and the United States [35,36] demonstrating the cost-effectiveness of screening and incidental nodule programs.…”

Section: Discussionsupporting

confidence: 76%

Development and outcomes of a comprehensive multidisciplinary incidental lung nodule and lung cancer screening program

et al. 2020

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Background: Appropriate management of lung nodules detected incidentally or through lung cancer screening can increase the rate of early-stage diagnoses and potentially improve treatment outcomes. However, the implementation and management of comprehensive lung nodule programs is challenging. Methods: This single-center, retrospective report describes the development and outcomes of a comprehensive lung nodule program at a community practice in Tennessee. Computed tomography (CT) scans potentially revealing incidental lung nodules were identified by a computerized search. Incidental or screening-identified lung nodules that were enlarging or not seen in prior scans were entered into a nodule database and guideline-based review determined whether to conduct a diagnostic intervention or radiologic follow-up. Referral rates, diagnosis methods, stage distribution, treatment modalities, and days to treatment are reported. Results: The number of patients with lung nodules referred to the program increased over 2 years, from 665 patients in Year 1 to 745 patients in Year 2. Most nodules were incidental (62-65%). Nodules identified with symptoms (15.2% in Year 1) or through screening (12.6% in Year 1) were less common. In Year 1, 27% (182/665) of nodules required a diagnostic intervention and 18% (121/665) were malignant. Most diagnostic interventions were image-guided bronchoscopy (88%) or percutaneous biopsy (9%). The proportion of Stage I-II cancer diagnoses increased from 23% prior to program implementation to 36% in Year 1 and 38% in Year 2. In screening cases, 71% of patients completed follow-up scans within 18 months. Only 2% of Year 1 patients under watchful waiting required a diagnostic intervention, of which 1% received a cancer diagnosis. Conclusions: The current study reports outcomes over the first 2 years of a lung cancer screening and incidental nodule program. The results show that the program was successful, given the appropriate level of data management and oversight. Comprehensive lung nodule programs have the potential to benefit the patient, physician, and hospital system.

show abstract

Section: Discussionsupporting

confidence: 76%

Development and outcomes of a comprehensive multidisciplinary incidental lung nodule and lung cancer screening program

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Most of those interventions were minimally invasive ENBguided and EBUS-guided bronchoscopy procedures. Although we did not conduct a formal costeffectiveness analysis, our results support prior publications from Europe [32], the United Kingdom [33], Asia [34], and the United States [35,36] demonstrating the cost-effectiveness of screening and incidental nodule programs.…”

Section: Discussionsupporting

confidence: 76%

Development and outcomes of a comprehensive multidisciplinary incidental lung nodule and lung cancer screening program

LeMense

Waller²,

Campbell³

et al. 2020

Preprint

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Background: Appropriate management of lung nodules detected incidentally or through lung cancer screening can increase the rate of early-stage diagnoses and potentially improve treatment outcomes. However, the implementation and management of comprehensive lung nodule programs is challenging. Methods: This single-center, retrospective report describes the development and outcomes of a comprehensive lung nodule program at a community practice in Tennessee. Computed tomography (CT) scans potentially revealing incidental lung nodules were identified by a computerized search. Incidental or screening-identified lung nodules that were enlarging or not seen in prior scans were entered into a nodule database and guideline-based review determined whether to conduct a diagnostic intervention or radiologic follow-up. Referral rates, diagnosis methods, stage distribution, treatment modalities, and days to treatment are reported. Results: The number of patients with lung nodules referred to the program increased over 2 years, from 665 patients in Year 1 to 745 patients in Year 2. Most nodules were incidental (62%-65%). Nodules identified with symptoms (15.2% in Year 1) or through screening (12.6% in Year 1) were less common. In Year 1, 27% (182/665) of nodules required a diagnostic intervention and 18% (121/665) were malignant. Most diagnostic interventions were image-guided bronchoscopy (88%) or percutaneous biopsy (9%). The proportion of Stage I-II cancer diagnoses increased from 23% prior to program implementation to 36% in Year 1 and 38% in Year 2. In screening cases, 71% of patients completed follow-up scans within 18 months. Only 2% of Year 1 patients under watchful waiting required a diagnostic intervention, of which 1% received a cancer diagnosis. Conclusions: The current study reports outcomes over the first two years of a lung cancer screening and incidental nodule program. The results show that the program was successful, given the appropriate level of data management and oversight. Comprehensive lung nodule programs have the potential to benefit the patient, physician, and hospital system.

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“…Demonstrating that a lung cancer screening clinic can not only support itself, but also potentially contribute to the organization's margin, is paramount in gaining the attention and support of hospital administration. As we continue to weigh the cost-effectiveness of lung cancer screening on a societal and local level, Gilbert and colleagues 4 should be congratulated for bringing us 1 step closer with this study.…”

mentioning

confidence: 99%

“…In addition, payer mix will certainly influence the revenue generated by such a clinic. Despite these variables, this article by Gilbert and colleagues 4 is an important contribution to the literature at a time when hospital resources are tightly guarded and return on investment is heavily scrutinized.…”

mentioning

confidence: 99%

Lung cancer screening is here to stay, but does it pay?

Seder

2018

The Journal of Thoracic and Cardiovascular Surgery

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The economic impact of a nurse practitioner–directed lung cancer screening, incidental pulmonary nodule, and tobacco-cessation clinic

Cited by 22 publications

References 24 publications

Development and outcomes of a comprehensive multidisciplinary incidental lung nodule and lung cancer screening program

Development and outcomes of a comprehensive multidisciplinary incidental lung nodule and lung cancer screening program

Development and outcomes of a comprehensive multidisciplinary incidental lung nodule and lung cancer screening program

Lung cancer screening is here to stay, but does it pay?

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