Management of Pulmonary Nodules by Pulmonologists

Pulmonary nodules are noted frequently on chest computed tomography (CT) that is done to evaluate chest symptoms or screen for lung cancer. To determine whether pulmonologists are evaluating nodules according to guidelines published by the American College of Chest Physicians (ACCP; Chest 2013; 143[5_suppl]:e93S), researchers reviewed records of 377 patients with “intermediate” pulmonary nodules (i.e., those measuring 8–20 mm) who were referred to 18 U.S. community-based pulmonary clinics.

The researchers focused on intermediate-sized nodules because their management is especially complex, requiring estimates of pretest probability of malignancy (preferably using one of several available quantitative models). Guidelines classify nodules as l…