The development and application of a novel precise health management model for pulmonary nodules population: a prospective cohort study

Background: The early screening of lung cancer faces issues such as overtreatment, complex patient visits processes, poor adherence, and significant psychological harm. The purpose of this study was to develop a novel precise health management model for lung nodule patients aimed at optimizing patient management processes. Methods: Two thousand eight hundred sixteen consecutive patients undergoing early lung cancer screening at our department were included in the study. A new management model has been developed that incorporates a structured follow-up script system and a level-to-level multidisciplinary treatment approach. The patients were divided into the following two groups: intervention group (Group A) was managed using the new model, and control group (Group B) was managed using a traditional model. Timely follow-up visits, the average cumulative effective dose (ED), the proportion percentage of patients who have surgery at the hospital, the proportion percentage of benign nodules in the surgical patients, the proportion percentage of patients diagnosed with malignant tumors in Tumor Node Metastasis (TNM) stage I after surgery, and the follow-up interval for the low-risk pulmonary nodule (PN) patients were evaluated between the two groups. Results: In total, 1,178 patients in the intervention group and 1,638 patients in the control group were included in the study. The loss to follow up rate was significantly lower in the intervention group than the control group (28.5% versus 32.5%, P=0.03). The intervention group had a significantly higher rate of timely return visits than the control group (60.3% versus 53.0%, P=0.001). The average cumulative ED of radiation was significantly lower in the intervention group than the control group (4.611±3.909 versus 5.631±5.345 mSv, P=0.001). The incidence of postoperative benign lesions decreased from 13.0% to 3.0% under the novel model in the intervention group. Conclusions: Our model provided a more rational and effective management strategy for PNs. This approach simplified the process steps for a patient visit, improved patients’ adherence, reduced radiation exposure, avoided overdiagnosis and overtreatment, and reduced psychological harm.