Pulmonary nodules app being used in the clinic.

A new smartphone app* has been launched today (Tuesday) to help guide doctors on the next steps for patients who have small masses of tissue in their lungs – known as pulmonary nodules.

“Moving beyond selfies, social media and playlists, this app is designed to support clinicians in their decision-making so we can help ensure the right people are getting the right tests at the right time.” – Dr Jodie Moffat, Cancer Research UK

These nodules are common and most are harmless – but some can be cancerous and need treatment. They appear as round, white shadows on a chest X-ray or CT scan.

Cancer Research UK – in partnership with the British Thoracic Society – used their in-house digital experts to develop a free iOS (iPhone, iPad etc.)** app for doctors, nurses and technicians examining people with pulmonary nodules.

The app gives medics quick and easy access to guidelines developed by the British Thoracic Society, along with risk and growth calculators, turning the mobile phone into a powerful way to accurately manage nodules.

At the moment, respiratory clinicians and radiologists use CT scans and information from patient records to help decide how best to manage patients who have pulmonary nodules.

The app will provide additional information to help clinicians quickly and accurately identify who is at risk and needs further investigations while avoiding unnecessary testing and worry for patients with nodules which are likely to be benign.

Guidelines and calculators in the app help clinicians decide what the next best steps are for their patients – whether to discharge them, bring them back for monitoring in the future or to proceed with more tests to confirm a lung cancer diagnosis and provide appropriate treatment.

This new easy-to-use app brings together the guidelines and calculators together into one place, allowing clinical staff to decide the next steps quickly.

To ensure the app is straight forward, reliable and provides the right advice, Cancer Research UK worked with doctors, radiologists and nurses across the country throughout the development process. More than 40 clinicians provided advice and feedback on the design of the app and confirmed there is huge demand for quick and simple solutions to support their decision-making.

Dr Jodie Moffat, Cancer Research UK’s head of early diagnosis, said: “Mobile phones have become essential tools in most people’s everyday lives. Moving beyond selfies, social media and playlists, this app is designed to support clinicians in their decision-making so we can help ensure the right people are getting the right tests at the right time. Using smartphones to put this knowledge into clinicians’ hands will enable them make the best possible choices more quickly and efficiently, helping to speed up the time it takes to diagnose lung cancer. Ensuring that patients who need further tests get these quickly is another step towards diagnosing lung cancer as swiftly as possible.”

Professor David Baldwin, Consultant Respiratory Physician at Nottingham University Hospitals and member of the British Thoracic Society, said: “The new app is a very useful tool for healthcare professionals to help guide their assessment, diagnosis and treatment of pulmonary nodules ensuring that management is evidence based.

“It builds on the existing and very popular ‘BTS Pulmonary Nodule Risk Prediction Calculator’ and we’re delighted to have partnered with Cancer Research UK to develop the app so that it will make the guideline so much more accessible via the App Store. It means that many more practitioners will be able to access the essential elements of the guideline on the go, and in different settings within the hospital.”


* https://itunes.apple.com/us/app/pulmonary-nodule-risk/id1142255949?ls=1&mt=8

** The app is currently only available for iPhones. The development team will monitor demand to see if a version for Android or Windows phones is needed.

The online version of the calculator has been used more than 18,700 times so far this year.

This app is designed as a tool for clinicians. Patients concerned about their lung health or scan results, should speak to their doctor or GP. They can also look at Cancer Research UK’s patient information website and talk to Cancer Research UK’s cancer information nurses online or by phone.

Survival remains low for people with lung cancer and progress is urgently needed. Cancer Research UK has committed to increase its investment in lung cancer research and has an ambition to spark sustained growth in research by bringing people together, building infrastructure and developing the next generation of research leaders.

The key features of the app are the Brock and Herder risk prediction and volume doubling time (VDT) calculators that are recommended by the British Thoracic Society (BTS) to assist in the diagnosis and management of pulmonary nodules.  Associated recommendations from the BTS on patient management have also been included.

The calculators and management algorithms should be used in conjunction with the full BTS Guidelines published in 2015 (Thorax 70, Supplement 2).

The app includes the four management algorithms that appear in the full guideline document and summarise key parts of the guidelines.

Instrumental to the development of the app have been the former co-chairs of the BTS Guideline  Group for the Investigation and Management of Pulmonary Nodules, Professor David Baldwin, Consultant Respiratory Physician at Nottingham University Hospitals, and Dr Matthew Callister, Consultant Respiratory Physician at St James’s University Hospital, Leeds.