a Record control number 000344816700036

a ISSN 1932-6203

a Original cataloging agency NEU GrandLibrary

a Language code of text/sound track or separate title eng

a Classification number W 84.61

b Item number .I47 2014

a Personal name Guldbrandt, Louise Mahncke.

h Medium Electronic Document

a Title Implementing Direct Access to Low-Dose Computed Tomography in General Practice-Method, Adaption and Outcome

c Statement of responsibility, etc Louise Mahncke Guldbrandt, Torben Riis Rasmussen, Finn Rasmussen, Peter Vedsted.

c Date of publication, distribution, etc 2014.

b Name of publisher, distributor, etc Public Library Science,

a Place of publication, distribution, etc San Francisco,

a Summary, etc Background: Early detection of lung cancer is crucial as the prognosis depends on the disease stage. Chest radiographs has been the principal diagnostic tool for general practitioners (GPs), but implies a potential risk of false negative results, while computed tomography (CT) has a higher sensitivity. The aim of this study was to describe the implementation of direct access to low-dose CT (LDCT) from general practice. Methods: We conducted a cohort study nested in a randomised study. A total of 119 general practices with 266 GPs were randomised into two groups. Intervention GPs were offered direct access to chest LDCT combined with a Continuing Medical Education (CME) meeting on lung cancer diagnosis. Results: During a 19-month period, 648 patients were referred to LDCT (0.18/1000 adults on GP list/month). Half of the patients needed further diagnostic work-up, and 15 (2.3%, 95% CI: 1.3-3.8%) of the patients had lung cancer; 60% (95% CI: 32.3-83.7%) in a localised stage. The GP referral rate was 61% higher for CME participants compared to non-participants. Conclusion: Of all patients referred to LDCT, 2.3% were diagnosed with lung cancer with a favourable stage distribution. Half of the referred patients needed additional diagnostic work-up. There was an association between participation in CME and use of CT scan. The proportion of cancers diagnosed through the usual fast-track evaluation was 2.2 times higher in the group of CME-participating GPs. The question remains if primary care case-finding with LDCT is a better option for patients having signs and symptoms indicating lung cancer than a screening program. Whether open access to LDCT may provide earlier diagnosis of lung cancer is yet unknown and a randomised trial is required to assess any effect on outcome.

a Topical term or geographic name as entry element Primary-Care Patients

a Topical term or geographic name as entry element Near East University Article

a Topical term or geographic name as entry element Yakın Doğu Üniversitesi Makale

a Topical term or geographic name as entry element Lung-Cancer

a Topical term or geographic name as entry element Multidisciplinary Sciences

a Topical term or geographic name as entry element Diagnosis

g Relationship information NOV 10 2014, Vol 9 Issue 11

x International Standard Serial Number 19326203

t Title Plos One

u Uniform Resource Identifier http://library.neu.edu.tr:2048/login?url=http://dx.doi.org/10.1371/journal.pone.0112162