Evidence map›Paper›PMID 39803962›Full record

ArticleJournal of the American College of Surgeons2025

Leveraging Artificial Intelligence as a Safety Net for Incidentally Identified Lung Nodules at a Tertiary Center.

Palina Woodhouse, Rafael Paez, Patrick Meyers, Rob J Lentz, Samira Shojaee, Kenneth Sharp, Nikki Baldi, Fabien Maldonado, Eric L Grogan

Abstract read
In one paragraph

Article in Journal of the American College of Surgeons, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Palina WoodhouseFrom the Departments of Thoracic Surgery (Woodhouse, Meyers, Sharp, Grogan), VA Tennessee Valley Healthcare System, Nashville, TN.
Rafael PaezAllergy, Pulmonary and Critical Care Medicine (Paez, Lentz, Shojaee, Baldi, Maldonado), VA Tennessee Valley Healthcare System, Nashville, TN.
Patrick MeyersFrom the Departments of Thoracic Surgery (Woodhouse, Meyers, Sharp, Grogan), VA Tennessee Valley Healthcare System, Nashville, TN.
Rob J LentzAllergy, Pulmonary and Critical Care Medicine (Paez, Lentz, Shojaee, Baldi, Maldonado), VA Tennessee Valley Healthcare System, Nashville, TN.
Samira ShojaeeAllergy, Pulmonary and Critical Care Medicine (Paez, Lentz, Shojaee, Baldi, Maldonado), VA Tennessee Valley Healthcare System, Nashville, TN.
Kenneth SharpFrom the Departments of Thoracic Surgery (Woodhouse, Meyers, Sharp, Grogan), VA Tennessee Valley Healthcare System, Nashville, TN.
Nikki BaldiAllergy, Pulmonary and Critical Care Medicine (Paez, Lentz, Shojaee, Baldi, Maldonado), VA Tennessee Valley Healthcare System, Nashville, TN.
Fabien MaldonadoAllergy, Pulmonary and Critical Care Medicine (Paez, Lentz, Shojaee, Baldi, Maldonado), VA Tennessee Valley Healthcare System, Nashville, TN.
Eric L GroganFrom the Departments of Thoracic Surgery (Woodhouse, Meyers, Sharp, Grogan), VA Tennessee Valley Healthcare System, Nashville, TN.

Funding

Validation of Biomarkers of Risk for the Early Detection of Lung CancerU01CA152662 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI DEPPEN, STEPHEN, GROGAN, ERIC L · 2010 to 2025
$12.8M
Clinical and Translational Training Program in Pulmonary MedicineT32HL087738 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Lorraine B Ware · 2007 to 2026
$7.0M
Surgical Oncology Training GrantT32CA106183 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI James Richard Goldenring · 2004 to 2026
$6.0M
Clinical Utility of Biomarkers Driven Management of Indeterminate Pulmonary NodulesR01CA252964 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Eric L Grogan, Alexander Mark Kaizer · 2021 to 2026
$3.3M
NCI NIH HHS R01 CA252964NCI NIH HHS T32 CA106183NCI NIH HHS U01 CA152662NHLBI NIH HHS T32 HL087738
6 · The paper itself

Abstract

backgroundArtificial intelligence (AI)-powered platforms may be used to ensure that clinically significant lung nodules receive appropriate management. We studied the impact of a commercially available AI natural language processing tool on the detection of clinically significant indeterminate pulmonary nodules (IPNs) based on radiology reports and provision of guideline-consistent care. STUDY

designAll CT scans performed at a single tertiary care center in the outpatient or emergency room setting between February 20, 2024, and March 20, 2024, were processed by the AI natural language processing algorithm. CT radiology reports mentioning a lung nodule or focal indeterminate lesion were flagged. All flagged reports were reviewed by a lung nodule expert 2 weeks after nodule identification. IPNs were classified as "appropriately followed" if follow-up imaging, referral to a nodule clinic, or other guideline-consistent care was ordered. IPNs were classified as "not appropriately followed" if no acknowledgment of the reported nodule was documented in the electronic health record within 2 weeks of being flagged.

resultsThe AI software processed 76,507 unique radiology reports, identified 2,585 CT scans with chest imaging, and found 389 IPNs. Review determined that 272 (70%) nodules were appropriately followed, whereas 117 (30%) were not appropriately followed. Of the 117 nodules without documented follow-up, 67 (57%) were more than 8 mm and 24 (20.5%) were more than 15 mm. IPNs that would not have received follow-up in the absence of the AI software generated 43 additional clinical appointments and 3 procedures.

conclusionsAt a large tertiary care center, 30% of clinically significant incidental pulmonary nodules that would have otherwise been missed were brought to the attention of lung nodule clinicians by an AI software, allowing for initiation of appropriate follow-up.

Indexed as

Artificial IntelligenceLung NeoplasmsMultiple Pulmonary NodulesSolitary Pulmonary NoduleAgedElectronic Health RecordsFemaleHumansIncidental FindingsMaleMiddle AgedNatural Language ProcessingRetrospective StudiesSafety-net ProvidersTertiary Care CentersTomography, X-Ray Computed

Identifiers

PMID39803962
PMCPMC11928252

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.