Immediate chest X-ray for patients at risk of lung cancer presenting in primary care: randomised controlled feasibility trial

Neal, Richard D; Barham, Allan; Bongard, Emily; Edwards, Rhiannon Tudor; Fitzgibbon, Jim; Griffiths, Gareth; Hamilton, William; Hood, Kerenza; Nelson, Annmarie; Parker, David; Porter, Catharine; Prout, Hayley; Roberts, Kirsty; Rogers, Trevor; Thomas-Jones, Emma; Tod, Angela; Yeo, Seow Tien; Hurt, Chris

doi:10.1038/bjc.2016.414

Cited by 15 publications

(16 citation statements)

References 33 publications

(31 reference statements)

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“…Twenty of the 22 studies used the ICECAP-O tariff values [ 8 ] to translate responses to the measure into an overall score; two studies [ 56 , 68 ] were pilot/feasibility studies which aimed to test the feasibility of using the measure with particular patient populations, rather than analyse or interpret the results.…”

Section: Resultsmentioning

confidence: 99%

ICECAP-O, the current state of play: a systematic review of studies reporting the psychometric properties and use of the instrument over the decade since its publication

2019

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Purpose A paper reporting the development of the ICECAP-O was published in 2006. Since then, there has been increasing interest in the use of capability-based measures within health economics and the ICECAP-O has been suggested for use in economic evaluation by decision-making bodies in the Netherlands and UK. Methods A systematic review of studies published between January 2006 and October 2018 which have assessed the psychometric properties of ICECAP-O or utilised the measure within economic evaluation. Results Twenty-four studies explored the psychometric properties of ICECAP-O and 21 have utilised the measure within economic evaluation; one study reported psychometric properties as well as utilising the measure within economic evaluation. The ICECAP-O has good construct validity and responsiveness, but there is evidence of some issues relating to content validity. In the context of economic evaluation, the ICECAP-O has, to date, mainly been included as a secondary economic measure and the reporting of results is brief with minimal detail and often no discussion. Five of the economic evaluation studies combined scores from ICECAP-O with time, but each used different terminology to describe this result. Conclusion Focus, in terms of publications, appears to have shifted now from assessment of psychometric properties to the utilisation of the ICECAP-O within economic evaluation. Further research is needed with respect to a decision-rule for the ICECAP measures. This additional research should also guide users in terms of appropriate analysis, terminology and presentation of results, which are in-keeping with the conceptual framework underpinning the ICECAP-O. Electronic supplementary material The online version of this article (10.1007/s11136-019-02114-y) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

ICECAP-O, the current state of play: a systematic review of studies reporting the psychometric properties and use of the instrument over the decade since its publication

2019

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“…Patients with lung cancer often have multiple GP visits about respiratory symptoms before referral to a specialist for definitive diagnosis 36. By highlighting that these patients are at increased risk of lung cancer, they could potentially be investigated sooner by their GP and reduce the overall diagnostic interval 37…”

Section: Discussionmentioning

confidence: 99%

The Chest Australia Trial: a randomised controlled trial of an intervention to increase consultation rates in smokers at risk of lung cancer

Emery

Murray

Walter

et al. 2019

Thorax

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BackgroundInternational research has focused on screening and mass media campaigns to promote earlier patient presentation and detect lung cancer earlier. This trial tested the effect of a behavioural intervention in people at increased risk of lung cancer on help-seeking for respiratory symptoms.MethodsParallel, individually randomised controlled trial. Eligible participants were long-term smokers with at least 20 pack-years, aged 55 and above. The CHEST intervention entailed a consultation to discuss and implement a self-help manual, followed by self-monitoring reminders to encourage help-seeking for respiratory symptoms. The control group received a brief discussion about lung health. Both groups had baseline spirometry. Telephone randomisation was conducted, 1:1, stratified Medical Research Council (MRC) dyspnoea score and general practice. Participants could not be blinded; data extraction and statistical analyses were performed blinded to group assignment. The primary outcome was respiratory consultation rates.ResultsWe randomised 551 participants (274 intervention, 277 control) from whom the primary outcome was determined for 542 (269 intervention, 273 control). There was a 40% relative increase in respiratory consultations in the intervention group: (adjusted rates (95% CI) intervention 0.57 (0.47 to 0.70), control 0.41 (0.32 to 0.52), relative rate 1.40 (1.08 to 1.82); p=0.0123). There were no significant differences in time to first respiratory consultation, total consultation rates or measures of psychological harm. The incremental cost-effectiveness ratio was $A1289 per additional respiratory consultation.ConclusionsA behavioural intervention can significantly increase consulting for respiratory symptoms in patients at increased risk of lung cancer. This intervention could have an important role in primary care as part of a broader approach to improve respiratory health in patients at higher risk.Trial registration numberAustralian New Zealand Clinical Trial Registry (1261300039 3752). This was registered pre-results.

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“…Adeli is with Stanford University, Stanford, CA, USA. -radiography remains the most prevalent screening test for pulmonary disorders [54]- [56]. Due to overlapping organs, low resolution and subtle anatomical shape and size variations, interpreting CXR images accurately remains challenging and requires well-trained staff.…”

Section: Introductionmentioning

confidence: 99%

Image-to-Images Translation for Multi-Task Organ Segmentation and Bone Suppression in Chest X-Ray Radiography

Eslami

Tabarestani

Albarqouni

et al. 2020

IEEE Trans. Med. Imaging

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Chest X-ray radiography is one of the earliest medical imaging technologies and remains one of the most widelyused for the diagnosis, screening and treatment follow up of diseases related to lungs and heart. The literature in this field of research reports many interesting studies dealing with the challenging tasks of bone suppression and organ segmentation but performed separately, limiting any learning that comes with the consolidation of parameters that could optimize both processes. Although image processing could facilitate computer aided diagnosis, machine learning seems more amenable in dealing with the many parameters one would have to contend with to yield an near optimal classification or decision-making process. This study, and for the first time, introduces a multitask deep learning model that generates simultaneously the bonesuppressed image and the organ segmented image, minimizing as a consequence the number of parameters the model has to deal with and optimizing the processing time as well; while at the same time exploiting the interplay in these parameters so as to benefit the performance of both tasks. The design architecture of this model, which relies on a conditional generative adversarial network, reveals the process on how we managed to modify the well-established pix2pix network to fit the need for multitasking and hence extending the standard image-to-image network to the new image-to-images architecture. Dilated convolutions are also used to improve the results through a more effective receptive field assessment. A comparison of the proposed approach to state-of-the-art algorithms is provided to gauge the merits of the proposed approach.

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Immediate chest X-ray for patients at risk of lung cancer presenting in primary care: randomised controlled feasibility trial

Cited by 15 publications

References 33 publications

ICECAP-O, the current state of play: a systematic review of studies reporting the psychometric properties and use of the instrument over the decade since its publication

ICECAP-O, the current state of play: a systematic review of studies reporting the psychometric properties and use of the instrument over the decade since its publication

The Chest Australia Trial: a randomised controlled trial of an intervention to increase consultation rates in smokers at risk of lung cancer

Image-to-Images Translation for Multi-Task Organ Segmentation and Bone Suppression in Chest X-Ray Radiography

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