Testing of recommendations
Finally, the recommendations were tested by physicians
targeted by the guidelines. A total of 253
patients were considered in the analysis. The complete
results are currently being processed. Twenty
per cent of patients were seen at a screening or early
diagnostic phase, 52% at a surgical decision stage
and 28% during follow-up after a surgical procedure
or a decision not to operate. Most chnical situations
had been considered in the penultimate version of
the guidelines. Three new situations were identified
where recommendations were lacking: pregnancy (8/
213 women), large nodule size (> 4 cm in 3.6% of
patients) and intrathoracic nodules. Twenty-two per
cent of respondents expressed a partial (and sometimes
total) disagreement with the guidehnes. Disagreement
mainly concerned limited availability of diagnostic examinations and a gap between usual
management and the recommended management.