EVALUNG - Evaluation and quality assurance in the extended screening program of the German Social Accident Insurance for early detection of asbestos-related lung diseases using low-dose computed tomography

Status:

ongoing

Aims:

The aim is to develop, plan and implement a concept for scientific evaluation and quality assurance of screening programs such as the EVA-Lunge in order to be able to generate sound data on the implementation and effectiveness of early detection for lung cancer using LD-HRCT. Using quality indicators and performing analyses will allow to determine important outcome parameters such as the detection rate of lung cancer, the rate of so-called false-positive findings, the rate of diagnostic work-up after LD-HRCT examination or the number of potential recognition of occupational disease no. 4104 (lung cancer) generated from the screening program. Parameters will be recorded overall and stratified - e.g. according to examination round (initial, subsequent examinations), participant characteristics or region. Furthermore, attitudes towards, subjective perceptions of, and psychological strain in relation to EVA-Lunge among insured persons will be assed using qualitative research. Additionally, knowledge and attitudes towards lung cancer screening using LD-HRCT among physicians will be investigated.

Activities/Methods:

At the beginning of the project, a detailed as-is analysis (processes, data flows, data quality, challenges) of the early detection program EVA-Lunge, which started nationwide in 2018, will be conducted. Based on analysis results, a comprehensive and suitable concept for data flows, databases and data protection will be developed, piloted and implemented. In parallel, a comprehensive concept for quality assurance including a set of specific indicators will be developed and integrated into existing quality assurance measures. For outcome evaluation, results of the individual screening rounds will be examined using cross-sectional study design. Longitudinal analyses in a cohort approach will be exemplarily tested in a feasibility study. Primary endpoints are incidence of and mortality from lung cancer, secondary endpoints encompass other cancers and all-cause mortality. The study population currently potentially comprises about 22,000 insured persons from regular follow-up screening of asbestos-exposed workers as well as several thousand insured persons with recognized occupational disease no. 4103 (asbestosis or disease of the pleura caused by asbestos dust). Qualitative interviews with insured persons and physicians will be carried out to gain additional insights regarding psychological strain, knowledge, perception and attitudes related to LD-HRCT screening for lung cancer in general and the offered screening program in particular.

Last Update: