Table 3.

Indications for referral to primary care and recommended primary care actions.

LHC clinical scenario or LDCT incidental findings	Recommended primary care action
Obstructive spirometry with chronic cough or dyspnoea; no known diagnosis of COPD or asthma	COPD review
Moderate or severe coronary artery calcification on LDCT; not already taking lipid-lowering therapy, and not known to have a history of ischaemic heart disease	QRISK® cardiovascular risk assessment score12,13
Moderate or severe aortic valve calcification, or evidence of other cardiac valve disease	Echocardiogram referral
Aortic aneurysms (referred only via primary care if nonurgent)	Vascular or cardiothoracic referral, and/or echocardiogram referral
Dilated pulmonary artery suggestive of pulmonary hypertension	Echocardiogram referral
Other imaging finding requiring further primary care investigation or referral •Suspicious liver, adrenal, or renal lesions •Suspected pneumonia •Miscellaneous musculoskeletal findings	Referrals as specified by radiologist: •Imaging or biochemical tests or onward referral •For clinical assessment •Recommendations for investigation at discretion of reporting radiologist