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Gurmohan Rob Dhillon

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    MA24 - Initiatives to Improve Health in Lung Cancer Patients (ID 354)

    • Event: WCLC 2019
    • Type: Mini Oral Session
    • Track: Advocacy
    • Presentations: 1
    • Now Available
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      MA24.07 - Impact of Radiologist Recommendations on Timeliness of Lung Cancer Referral: Baseline Data to Guide a Quality Improvement Initiative (Now Available) (ID 828)

      14:30 - 16:00  |  Author(s): Gurmohan Rob Dhillon

      • Abstract
      • Presentation
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      Lung cancer (LC) diagnostic pathways are typically initiated following suspicious radiographic imaging. In southeastern Ontario, Canada, we identified delays from first thoracic imaging suspicious for LC to referral for evaluation at our regional LC rapid assessment clinic, the Lung Diagnostic Assessment Program (LDAP). Given that delays in diagnosis of LC are associated with worse patient outcomes, we sought to characterize local processes to guide Quality Improvement (QI) initiatives.


      We retrospectively reviewed all patients referred to the LDAP between January and October 2018. Collected data included dates of: first imaging suspicious for LC, first CT chest (if different from first suspicious imaging), LDAP referral, LDAP assessment, and details regarding Radiologist recommendations in the report. Data are reported as mean days (± standard error); unpaired t-tests were used to assess for significance.


      Of 558 patients referred to the LDAP, 509 (91.2%) patients had a CT chest performed prior to LDAP referral. Of these, 110 (21.6%) had a CT chest report issuing a specific Radiologist recommendation for LDAP referral. When such a recommendation was made, time from CT chest to LDAP referral was significantly faster than if no recommendation was made (6.9 versus 12.9 days, p=0.017), as was time from CT Chest to LDAP assessment (21.4 versus 25.6 days, p=0.026). Of all patients with a Radiologist recommended LDAP referral, 38 (34.5%) were not assessed in the LDAP for reasons including: patient followed by the LDAP, a Respirologist, or an Oncologist, inpatient status, or patient refusing assessment. Data are presented in Figure 1.

      figure 1.png


      We identified that a Radiologist recommendation for LDAP referral leads to significantly faster patient referral and assessment for evaluation of suspected LC. A QI initiative is underway, consisting of knowledge sharing and regional standardization of radiologist reporting recommendations for imaging suspicious for LC in order to expedite LDAP referral.

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