Table 2.
Inclusion and exclusion of diagnostic indicators at each Delphi round for lung cancer
| Diagnostic indicator | Round 1 (mean score for importance) | Round 2 (mean rank score) | Round 3 (crucial) |
|---|---|---|---|
| Key risk factor | |||
| Smoking statusa | 5.00 | 1.13 | Y |
| Occupational exposurea | 4.54 | 4.50 | Y |
| Agea | 4.33 | 3.31 | Y |
| Second attendance with the same symptoma | 4.25 | 8.25 | Y |
| History of chronic obstructive pulmonary diseasea | 4.13 | 6.81 | Y |
| Second-hand smoke exposurea | 4.04 | 7.00 | Y |
| Socioeconomic status | 3.71 | 7.19 | Nb |
| Family history (first-degree relative)a | 3.58 | 9.56 | Y |
| Last consultation with a GP >6 months ago | 3.46 | 12.88b | |
| History of idiopathic pulmonary fibrosis | 3.42 | 12.75b | |
| History of tuberculosis | 3.33 | 13.81b | |
| Sex | 3.25 | 11.19b | |
| Alcohol intake | 3.17 | 11.75b | |
| Ethnicityb | 2.79b | ||
| Last consultation with a GP >5 years agoc | 10.38 | Nb | |
| Patient thinks they may have lung cancera,c | 11.13 | Y | |
| Patient attends with an adult family memberc | 15.75b | ||
| Localisation of painc | 12.63b | ||
| Reduced exercise tolerancea,c | Y | ||
|
| |||
| Symptom | |||
| Haemoptysisa | 4.96 | 1.25 | Y |
| Unintentional loss of weight reported by patienta | 4.79 | 4.44 | Y |
| Symptom durationa,d | 4.25 | 6.19 | Y |
| Cougha | 4.17 | 3.00 | Y |
| Hoarsenessa | 4.13 | 6.06 | Y |
| Dyspnoeaa | 4.00 | 4.38 | Y |
| Chest paina | 3.79 | 6.69 | Y |
| Bone pain | 3.92 | 9.88b | |
| Loss of appetite | 3.88 | 7.88b | |
| Back pain | 3.88 | 10.56b | |
| Fatigue | 3.88 | 8.81b | |
| Shoulder pain | 3.75 | 8.88b | |
|
| |||
| Sign | |||
| Cachexiaa | 4.71 | 3.94 | Y |
| Pleural massa | 4.67 | ||
| Pleural effusiona | 4.67 | 3.69 | Y |
| Superior vena cava obstructiona | 4.58 | 3.31 | Y |
| Objective weight lossa | 4.54 | 4.5 | Y |
| Lymphadenopathya | 4.25 | 5.94 | Y |
| Stridora | 4.21 | 6.00 | Y |
| Finger clubbing | 4.00 | 7.31b | |
| Horner's syndromea,c | 6.50 | Y | |
|
| |||
| Test | |||
| Abnormal chest X-raya | 4.79 | 1.06 | Y |
| Abnormal sputum cytology | 4.13 | 3.75 | Nb |
| Anaemia | 3.71 | 3.69 | Nb |
| Raised erythrocyte sedimentation rate | 3.75 | 4.63b | |
| Raised C-reactive protein | 3.5 | 5.56b | |
| Abnormal spirometry | 3.33 | 6.06b | |
| Thrombocytosis | 3.25 | 7.31b | |
| Hypercalcaemiac | 6.81b | ||
| Disturbed liver function testsc | 6.13b | ||
a
Included in round 3.
b
Excluded in round 2.
c
Added by participants in round 1.
d
Refers to whether the symptom was present for a long period of time as opposed to only a short period.