Chest
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Individuals with cystic fibrosis (CF) diagnosed as adults represent a rare but growing subset of the CF population. Limited studies have described their lung function trajectories. ⋯ The lung function of who receive a diagnosis of CF as adults in the CCFR declines slowly compared with estimates from the overall adult CF population. Individuals with adult-diagnosed CF who are older and demonstrate pulmonary symptoms at diagnosis experience a faster rate of lung function decline and should be monitored more closely.
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Multicenter Study
Access to lung cancer screening in the Veterans Health Administration: Does geographic distribution match need in the population?
Studies show uneven access to Medicare-approved lung cancer screening (LCS) programs across the United States. The Veterans Health Administration (VA), the largest national US integrated health system, is potentially well positioned to coordinate LCS services across regional units to ensure that access matches distribution of need nationally. ⋯ Disparities in LCS access exist based on where Veterans live, particularly for rural Veterans, even after partnering with the GO2 Foundation for Lung Cancer. The nationally integrated VA system has an opportunity to leverage regional resources to distribute and coordinate LCS services better to ensure equitable access.
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Multicenter Study Observational Study
Ratio of Forced Expiratory Volume in 1 second /Slow Vital Capacity (FEV1/SVC)<0.7 is associated with clinical, functional, and radiologic features of obstructive lung disease in smokers with preserved lung function.
Mild expiratory flow limitation may not be recognized using traditional spirometric criteria based on the ratio of FEV1/FVC. ⋯ Low FEV1 to SVC in current and former smokers with normal spirometry results can identify individuals with CT scan features of COPD who are at risk for severe exacerbations and is associated with progression to COPD in the future.
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Lung cancer screening (LCS) reduces lung cancer mortality, but it also carries a range of risks. Shared decision-making (SDM) is a process of engaging patients in their health care decisions and is a vital component of LCS. ⋯ Among recently screened patients, the quality of decision-making about LCS is highly variable. The low use of educational materials including decision aids and imbalance of conveying benefit vs risk information to patients is concerning. A structured approach using decision aids may assist with providing a balanced presentation of information and may improve the quality of SDM.
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Multicenter Study Observational Study
Potential Disparities by Sex and Race or Ethnicity in Lung Cancer Screening Eligibility Rates.
Criteria for low-dose CT scan lung cancer screening vary across guidelines. Knowledge of the eligible pool across demographic groups can enable policy and programmatic decision-making, particularly for disproportionately affected populations. ⋯ Screening eligibility rates vary widely across guidelines, with disparities evident in E-I ratios, including among non-Hispanic Black men, despite higher lung cancer burden. Consideration of smoking duration in risk assessment criteria may address current disparities.