Investigating management of lung nodules
Investigating management of lung nodules, and the impact of pre-diagnostic surveillance on health and economic outcomes.
Imperial College Healthcare NHS Trust
Duration of Study in the UK
1 years, 3 months, 31 days
Lung cancer remains one of the biggest causes of cancer-related death within the UK, and most patients are still diagnosed at an advanced stage, when curative treatment is no longer an option. One opportunity for early detection of cancers is the identification and surveillance of nodules within the lung, which are often incidental findings. Guidelines exist to direct intervals for follow up, but there is recognised risk of variation in care within the UK, and no clear picture of numbers of patients with this condition, as there are no national registries.
This project seeks to calculate prevalence and describe the characteristics of patients diagnosed with lung nodules within clinical services (a ‘real-world’ cohort), which is important in guiding research into more personalised surveillance pathways in the future. It will also focus on describing and investigating variation in care pathways through process analysis. Comparing process maps with corresponding patient characteristics will help to evaluate what health and social inequalities might link to delays in lung cancer diagnosis.
Patients who are under lung nodule surveillance over a 6-month period in 2019 will be identified from Respiratory clinics at 10 NHS Hospitals across the West London region, and demographic and co-morbidity data will be collected. Approximately 200 patients from this cohort will then have their pathway mapped (20 patients per hospital) in terms of clinic appointments and CT scan dates. A process mining analysis will then be completed from the maps to describe bottlenecks in real-life pathways and visually describe variation from the guidelines. This will be correlated with demographic data to identify patient subgroups at risk of neglect or variation in their care. Economic costings for the pathways will also be applied, to understand the benefit to clinical services in reducing this variation. This work is funded by the West London Cancer Alliance.
London - Riverside Research Ethics Committee
Date of REC Opinion
17 Sep 2021