European Respiratory Society Guideline on various aspects of quality in lung cancer care

Abstract

This ERS guideline is dedicated to the provision of good quality recommendations in lung cancer care. All the clinical recommendations contained were based on a comprehensive systematic review and evidence syntheses based on eight PICO questions. The evidence was appraised in compliance with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Evidence profiles and the GRADE Evidence to Decision frameworks were used to summarise results and to make the decision-making process transparent. A multi-disciplinary task force panel of lung cancer experts formulated and consented the clinical recommendations following thorough discussions of the systematic review results.In particular, we have made recommendations relating to the following quality improvement measures deemed applicable to routine lung cancer care: 1) avoidance of delay in the diagnostic and therapeutic period, 2) the integration of multi-disciplinary teams and multi-disciplinary consultations, 3) the implementation of and adherence to lung cancer guidelines, 4) the benefit of higher institutional/individual volume and advanced specialisation in lung cancer surgery and other procedures, 5) the need for pathological confirmation of lesions in patients with pulmonary lesions and suspected lung cancer, histological subtyping and the molecular characterisation for actionable targets or response to treatment of confirmed lung cancers, 6) the added value of early integration of palliative care teams or specialists, 7) the advantage of integrating specific quality improvement measures, and 8) the benefit of using patient decision tools.These recommendations should be reconsidered and updated, as appropriate, as new evidence becomes available.