Abstract:
INTRODUCTION:The field of biomarker development is evolving to assist in determining benign from malignant pulmonary nodules. Although a prospective clinical utility would best to show how a biomarker affects patient treatment and outcomes, we sought to begin to understand how the results might alter management by determining how physicians would use the results of a rule-in blood test to manage pulmonary nodules. MATERIALS AND METHODS:Pulmonologists and thoracic surgeons in the American College of Chest Physicians clinician database were invited to participate in an online survey. The participant demographic data were collected. Four hypothetical clinical vignettes were presented. The participants accessed the pretest probability (probability of cancer [pCA]) for malignancy and chose the management strategies as the case progressed. The management strategies chosen before and after the result of a rule-in biomarker test were compared and assessed for guideline concordance. RESULTS:Of the 455 eligible participants who had opened the survey, 416 (92%) completed it: 332 pulmonologists and 84 thoracic surgeons. Although 91% of the participants were very comfortable managing nodules, depending on the case, 30% to 62% incorrectly assessed the pCA, with 22% to 62% overestimating the risk and 8% to 51% underestimating the risk. After a rule-in blood test result, the clinician change in management moved in the right direction in some cases but, in others, the physicians used the results incorrectly. Pulmonologists and thoracic surgeons differed in the management strategies, with surgeons recommending surgery more often. CONCLUSIONS:Although the use of biomarker testing for pulmonary nodule evaluation is promising, without proper physician education, the potential for harm exists. Clinical utility studies are needed to appropriately inform the effect of biomarker use.
journal_name
Clin Lung Cancerjournal_title
Clinical lung cancerauthors
Tanner NT,Brasher PB,Jett J,Silvestri GAdoi
10.1016/j.cllc.2019.05.004subject
Has Abstractpub_date
2020-03-01 00:00:00pages
e89-e98issue
2eissn
1525-7304issn
1938-0690pii
S1525-7304(19)30108-1journal_volume
21pub_type
杂志文章abstract:BACKGROUND:Gastric acid-suppressing medications (AS), namely, proton pump inhibitors and histamine-2 receptor antagonists, increase gastric pH, which may reduce the absorption of the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors-erlotinib and gefitinib. PATIENTS AND METHODS:From 2008 to 2011, 130 ...
journal_title:Clinical lung cancer
pub_type: 杂志文章
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更新日期:2016-09-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2013.11.001
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2017.05.009
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/CLC.2004.n.011
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pub_type: 杂志文章
doi:10.1016/j.cllc.2019.06.004
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/clc.2002.s.003
更新日期:2002-03-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2015.02.002
更新日期:2015-09-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2001-02-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2014.06.001
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2015.10.002
更新日期:2016-05-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章,随机对照试验
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更新日期:2015-11-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/clc.2000.n.018
更新日期:2000-08-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2014.10.003
更新日期:2015-03-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2013.09.003
更新日期:2014-03-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2018.08.020
更新日期:2019-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.cllc.2020.07.001
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2013.12.007
更新日期:2014-05-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2016.08.008
更新日期:2017-01-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章,评审
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更新日期:2009-01-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2011.11.003
更新日期:2012-07-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
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更新日期:2018-09-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章,评审
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更新日期:2005-12-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2012-11-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章,多中心研究
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更新日期:2019-01-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/clc.2000.s.008
更新日期:2000-12-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2011.03.019
更新日期:2011-05-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.cllc.2012.04.001
更新日期:2013-01-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章,评审
doi:10.3816/CLC.2005.n.031
更新日期:2005-11-01 00:00:00