The American College of Radiology (ACR) has been selected as one of seven recipients, each receiving a $100,000 planning grant aiming to assist medical specialty societies in developing diagnostic performance feedback through clinical registries. The 12-month grant will enable the ACR to develop a plan for expanding the ACR Lung Cancer Screening Registry (LCSR) to include a module for improved management of actionable incidental pulmonary nodules (IPNs).

The competitive grant program, funded by the Gordon and Betty Moore Foundation, is administered by the University of California, San Francisco (UCSF) and the Council of Medical Specialty Societies (CMSS).”

“We now know the early detection of lung cancer requires a combination of lung cancer screening of high-risk individuals, and the follow-up of incidentally detected pulmonary nodules. Among all incidentally detected findings on radiology examinations, IPNs are the most common significant—or potentially significant—finding requiring follow-up. Yet, sadly, workflows and processes are not in place to systematically make sure appropriate follow-up occurs,” says Ella Kazerooni, MD, MS, FACR, a physician co-advisor on this project.

The LCSR expansion will incorporate new measures, data collection, performance feedback reports and quality improvement tools to strengthen both lung cancer screening (LCS) and IPN programs. The work will leverage insights from previous ACR-led work on actionable incidental findings to enhance diagnostic performance in lung cancer care.

“We will focus diagnostic performance feedback both on the appropriateness of recommendations for imaging follow-up for IPNs and on tracking that completion of recommended imaging follow-up occurred during the recommended time range,” says Ben Wandtke, MD, MS, the project’s other physician co-advisor. “Additionally, we will define processes to provide clinicians feedback on the outcome of recommended follow-up, such as diagnosis of cancer.” 

UCSF, in partnership with CMSS, will serve as a coordinating center to promote cross-specialty learning, improvement, collaboration and identification of best practices in diagnostic performance feedback that can be shared with the broader medical community. 

Implementation grants will be awarded to a subset of grantees in phase 2 of the initiative to expand upon the phase 1 planning work.