Interventions to Improve Adherence to Clinical Guidelines for the Management and Follow-Up of Pulmonary Nodules: A Systematic Review.

It is also the third most common cancer in the United Kingdom and the most prevalent worldwide.

它也是英国第三常见的癌症，且是全球最普遍的癌症。

Pulmonary nodules can indicate early-stage lung cancer, but adherence to guidelines for radiologic surveillance is suboptimal, which affects early detection and treatment.

肺结节可能是早期肺癌的标志，但对放射学监测指南的遵循情况不佳，这影响了早期发现和治疗。

Although interventions have been developed to improve follow-up, it remains unclear which approaches are most effective.

尽管已经开发出一些干预措施来改善随访，但目前尚不清楚哪些方法最有效。

research_question

Which interventions have been developed for improving adherence to guidelines for the management of pulmonary nodules and/or the follow-up of patients, and how effective are they?

已经开发了哪些干预措施来改善对肺结节管理指南的遵从性以及/或者患者的随访，并且这些干预措施的有效性如何？

study_design_and_methods

A systematic reviewwas conducted by searching the Ovid MEDLINE, Cochrane, and Embase databases in March 2024.

2024年3月，通过搜索Ovid MEDLINE、Cochrane和Embase数据库进行了一项系统综述。

Reports were included of interventions of all designs that measured outcomes, including follow-up completion, guideline adherence, or early diagnosis of lung cancer.

纳入了所有设计类型的研究报告，这些报告测量了结果，包括随访完成率、指南依从性或肺癌的早期诊断。

Studies relating to diagnosis, reporting screening programs, or not in English were excluded.

排除了与诊断相关的研究、报告筛查计划的研究，或非英语的研究。

Screening and data extraction were performed independently.

筛选和数据提取是独立进行的。

Risk of bias was assessed by using three measures depending on study design.

根据研究设计，使用三种方法评估偏倚风险。

Results

A total of 3,664 titles and abstracts, including 31 studies, were identified.

共识别出3,664个标题和摘要，包括31项研究。

Six intervention types were identified: tracking systems, process improvement approaches, natural language processing systems, radiologist reporting templates, clinical decision-making support tools, and patient involvement improvements.

识别出六种干预类型：追踪系统、流程改进方法、自然语言处理系统、放射科医生报告模板、临床决策支持工具以及患者参与度改进。

All studies reported being effective.

所有研究均报告有效。

Tracking systems and clinical decision support tools showed significant improvements in follow-up, guideline adherence, and early cancer detection.

追踪系统和临床决策支持工具在随访、遵循指南和早期癌症检测方面显示出显著改善。

Tracking systems may have the most potential for effectiveness because they modify more of the care pathway and use automation, reducing human error.

追踪系统可能因其改变更多护理路径并采用自动化，减少了人为错误，因此具有最大的有效性潜力。

Risk of bias was serious or critical in most nonrandomized studies.

大多数非随机化研究中存在严重或关键的偏倚风险。

interpretation

Our results show that there was significant variation in achieved follow-up rates across interventions; however, tracking systems seemed most effective in improving patient follow-up.

我们的研究结果显示，在不同干预措施中，实现的随访率存在显著差异；然而，追踪系统似乎在提高患者随访方面最为有效。

Review limitations included high risk of bias and heterogeneity of included studies.

综述的局限性包括高偏倚风险和纳入研究的异质性。

Future evaluations should include more comprehensive outcome measures and rigorous designs.

未来的评估应包括更全面的结果指标和严谨的设计。