Scanagatta Paolo, Bertolini Alessandro, Naldi Giuseppe, Antoniazzi Francesca, Inzirillo Francesco, Giorgetta Casimiro Eugenio, Ravalli Eugenio, Ancona Gianluca, Cagnetti Sara, Barbonetti Claudio, Stangoni Fabiano
Division of Thoracic Surgery, Morelli Hospital, ASST Valtellina e Alto Lario, 23035 Sondalo (SO), Italy.
Department of Oncology, ASST Valtellina e Alto Lario, 23100 Sondrio (SO), Italy.
Life (Basel). 2025 Feb 25;15(3):362. doi: 10.3390/life15030362.
Lung cancer remains a leading cause of cancer-related mortality, with diagnostic delays significantly impacting patient outcomes. Despite advancements in diagnostic strategies, inefficiencies persist, particularly in geographically complex regions with limited healthcare resources. The Fast-Track Program was developed to address these challenges in lung cancer diagnostics within the geographically complex and resource-limited Valtellina region. This prospective observational study compared patients managed under the Fast-Track pathway (May-August 2024) with those following standard diagnostic procedures (January-April 2024). The program integrated structured, pre-scheduled diagnostic slots, a rotating Case Manager role, and weekly multidisciplinary team (MDT) discussions to enhance coordination and reduce diagnostic timelines. Results showed a significant reduction in the mean time to definitive diagnosis from 42.9 days (95% CI: 35.6-50.3) in the control group to 25.0 days (95% CI: 20.8-29.3) in the Fast-Track cohort ( < 0.001). Patient adherence to diagnostic pathways improved from 71% to 92% ( < 0.05), while satisfaction scores increased from 64% to 89%, with patients rating their experience as "very good" or "excellent" ( < 0.05). Although the predefined clinical significance criteria were not fully met, the program demonstrated a favorable trend toward improved efficiency and patient-centered care. These findings support the feasibility and scalability of structured diagnostic workflows in streamlining lung cancer diagnostics, with potential implications for broader oncological and chronic disease management in resource-constrained healthcare settings.
肺癌仍然是癌症相关死亡的主要原因，诊断延迟对患者预后有重大影响。尽管诊断策略有所进步，但效率低下的问题依然存在，尤其是在医疗资源有限、地理环境复杂的地区。快速通道计划旨在解决地理环境复杂且资源有限的瓦尔泰利纳地区肺癌诊断方面的这些挑战。这项前瞻性观察性研究将在快速通道路径下管理的患者（2024年5月至8月）与遵循标准诊断程序的患者（2024年1月至4月）进行了比较。该计划整合了结构化的、预先安排的诊断时段、轮流担任的病例管理角色以及每周的多学科团队（MDT）讨论，以加强协调并缩短诊断时间。结果显示，从对照组的确诊平均时间42.9天（95%CI：35.6 - 50.3）显著缩短至快速通道队列中的25.0天（95%CI：20.8 - 29.3）（<0.001）。患者对诊断路径的依从性从71%提高到了92%（<0.05），而满意度得分从64%提高到了89%，患者将他们的体验评为“非常好”或“优秀”（<0.05）。尽管未完全达到预定义的临床意义标准，但该计划显示出在提高效率和以患者为中心的护理方面的有利趋势。这些发现支持了结构化诊断工作流程在简化肺癌诊断方面的可行性和可扩展性，对资源有限的医疗环境中更广泛的肿瘤学和慢性病管理具有潜在意义。
