An Official American Thoracic Society Research Statement: A Research Framework for Pulmonary Nodule Evaluation and Management.
BACKGROUND
Pulmonary nodules are frequently detected during diagnostic chest imaging and as a result of lung cancer screening. Current guidelines for their evaluation are largely based on low-quality evidence, and patients and clinicians could benefit from more research in this area.


METHODS
In this research statement from the American Thoracic Society, a multidisciplinary group of clinicians, researchers, and patient advocates reviewed available evidence for pulmonary nodule evaluation, characterized six focus areas to direct future research efforts, and identified fundamental gaps in knowledge and strategies to address them. We did not use formal mechanisms to prioritize one research area over another or to achieve consensus.


RESULTS
There was widespread agreement that novel tests (including novel imaging tests and biopsy techniques, biomarkers, and prognostic models) may improve diagnostic accuracy for identifying cancerous nodules. Before they are used in clinical practice, however, better evidence is needed to show that they improve more distal outcomes of importance to patients. In addition, the pace of research and the quality of clinical care would be improved by the development of registries that link demographic and nodule characteristics with patient-level outcomes. Methods to share data from registries are also necessary.


CONCLUSIONS
This statement may help researchers to develop impactful and innovative research projects and enable funders to better judge research proposals. We hope that it will accelerate the pace and increase the efficiency of discovery to improve the quality of care for patients with pulmonary nodules.
Christopher G
http://orcid.org/0000-0003-0958-8122
CG
Slatore
Nanda
N
Horeweg
James R
JR
Jett
David E
DE
Midthun
Charles A
CA
Powell
Renda Soylemez
RS
Wiener
Juan P
JP
Wisnivesky
Michael K
MK
Gould
D032921:Consensus; D055088:Early Detection of Cancer; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D063868:Patient Outcome Assessment; D012955:Societies, Medical; D014481:United States