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Fig. 4 | BMC Health Services Research

Fig. 4

From: Reasons for prolonged time for diagnostic workup for stage I-II lung cancer and estimated effect of applying an optimized pathway for diagnostic procedures

Fig. 4

a Observed pathway. The optimal method for obtaining a tissue diagnosis was not always performed first, which led to more procedures. The most important reason for delays was that patients were referred for a PET CT too late during the diagnostic workup. The other main reason for delay was that exercise tests were not performed until after the tumor board discussions. Consequently, a treatment decision could often not be made during the tumor board meeting. b Our suggestions for an optimal pathway including median times for each procedure observed in our study cohort. The main points are that a PET CT and exercise test should be performed before the tumor board meeting and tissue sampling, and that patients should be referred for the most likely treatment before the results of the final diagnostic procedures are completed since the treatment seldom changes after the PET CT (in 2% of cases in our cohort)

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