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Guidelines by the European Respiratory Society: Quality Aspects in lung cancer care

The European Respiratory Society guideline offers quality recommendations in lung cancer care, including timely diagnosis, multidisciplinary teams, adherence to guidelines, and palliative care integration, based on systematic reviews and expert consensus.

The recommendations provided pertain to two distinct aspects of lung cancer care, focusing on time intervals and the involvement of multidisciplinary teams (MDT) in patient management.

Here’s a summary of each recommendation:

Timely Lung Cancer Care:

  • Recommendation: Minimize delays in starting treatment for lung cancer patients.
  • Approach: Collect waiting time data, establish standardized thresholds, monitor waiting times, and study the impact of longer wait times on advanced lung cancer survival.


MDT Involvement in Lung Cancer Care:

  • Recommendation: Integrate multidisciplinary teams (MDTs) into lung cancer management.
  • Approach: Harmonize MDT practices through a pan-European consensus, create benchmark tools, and optimize MDT processes through quality improvement initiatives.


Guideline Implementation and Adherence:

  • Recommendation: Implement and adhere to methodologically robust, evidence- based guidelines and standard operating procedures (SOPs) for lung cancer care with patient consent.
  • Approach: Establish active guideline cycles, monitor adherence through multicentric studies, and create new guideline models based on evidence and AI tools.


Higher Hospital and Surgeon Volume for Lung Cancer Surgery:

  • Recommendation: Perform lung cancer surgery in specialized thoracic surgery services with high institutional and individual surgeon volumes.
  • Approach: Research factors affecting procedural quality, define the volume of care thresholds, and improve procedural performance.


Volume of Care and Specialization for Other Procedures:

  • Recommendation: Perform non-surgical procedures in specialized lung cancer services with high institutional and individual procedural volumes.
  • Approach: Broaden research scope, optimize processes, assess patient characteristics and preferences, and define volume and specialization thresholds.


Pathological Confirmation of Suspected Lung Cancers:

  • Recommendation: Seek pathological confirmation in cases where it determines management for patients with suspected lung cancer.
  • Approach: Gather benchmarks through observational studies, and explore non- invasive diagnostic methods, such as liquid biopsies and imaging techniques.


Application of Quality Improvement Measures:

  • Recommendation: Utilize national clinical lung cancer registries with quality indicators to inform future lung cancer guidelines and services.
  • Approach: Conduct multicentral quality improvement studies, define quality elements, set up lung cancer service-based registries, and encourage population- based registries.


Access to Multiple Lung Cancer Specialist Facilities:

  • Recommendation: Refer lung cancer patients to services with ready access to multiple lung cancer specialist facilities.
  • Approach: Ensure reasonable proximity and timely access to these facilities.


Involvement of Patient Decision Tools:

  • Recommendation: Use patient decision tools to enhance patient involvement in decision-making for lung cancer patients.
  • Approach: Conduct behavioral and communication research, create various tool formats tailored to user preferences, define information contents and quality standards, and provide open-access tool repositories.


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