European Respiratory Society guideline on various aspects of quality in lung cancer care.

This European Respiratory Society guideline is dedicated to the provision of good quality recommendations in lung cancer care. All the clinical recommendations contained were based on a comprehensive systematic review and evidence syntheses based on eight PICO (Patients, Intervention, Comparison, Outcomes) questions. The evidence was appraised in compliance with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Evidence profiles and the GRADE Evidence to Decision frameworks were used to summarise results and to make the decision-making process transparent. A multidisciplinary Task Force panel of lung cancer experts formulated and consented the clinical recommendations following thorough discussions of the systematic review results. In particular, we have made recommendations relating to the following quality improvement measures deemed applicable to routine lung cancer care: 1) avoidance of delay in the diagnostic and therapeutic period, 2) integration of multidisciplinary teams and multidisciplinary consultations, 3) implementation of and adherence to lung cancer guidelines, 4) benefit of higher institutional/individual volume and advanced specialisation in lung cancer surgery and other procedures, 5) need for pathological confirmation of lesions in patients with pulmonary lesions and suspected lung cancer, and histological subtyping and molecular characterisation for actionable targets or response to treatment of confirmed lung cancers, 6) added value of early integration of palliative care teams or specialists, 7) advantage of integrating specific quality improvement measures, and 8) benefit of using patient decision tools. These recommendations should be reconsidered and updated, as appropriate, as new evidence becomes available.

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Déclaration de conflit d'intérêts

Conflict of interest: T.G. Blum reports an unrestricted grant from Stiftung Oskar-Helene-Heim (Berlin, Germany), through which staff support for the work of the current Task Force was provided. R.L. Morgan declares no competing interests. V. Durieux declares no competing interests. J. Chorostowska-Wynimko declares grants to the National Institute of Tuberculosis and Lung Diseases from Pfizer and to the Polish Respiratory Society from AstraZeneca; consulting fees from AstraZeneca, Pfizer, Amgen, Takeda, Merck Sharp & Dohme, Roche and Roche Diagnostica; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, Pfizer, CelonPharma, Amgen, Takeda, Novartis, Bristol Myers Squibb, Merck Sharp & Dohme, Roche, Roche Diagnostica and Amoy; support for attending meetings and/or travel from Bristol Myers Squibb, AstraZeneca, Merck Sharp & Dohme, Pfizer and Amgen; participation on a data safety monitoring board or advisory board for AstraZeneca, Pfizer, Takeda, Merck Sharp & Dohme, Roche and Roche Diagnostica, all in the 36 months prior to manuscript submission; and is Secretary General of the European Respiratory Society and a member of the Executive Committees of the Polish Respiratory Society and the Polish Coalition for Personalized Medicine. D.R. Baldwin declares payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Bristol Myers Squibb, AstraZeneca, Roche and Merck Sharp & Dohme, all in the 36 months prior to manuscript submission. J. Boyd is an employee of the European Lung Foundation. C. Faivre-Finn reports research grants from AstraZeneca and Elekta; payment or honoraria for presentations from AstraZeneca; support for attending meetings and/or travel from Elekta and AstraZeneca; and participation on a data safety monitoring board or advisory board for AstraZeneca and Merck Sharp & Dohme, all in the 36 months prior to manuscript submission. F. Galateau-Salle declares no competing interests. F. Gamarra declares no competing interests. B. Grigoriu declares support for attending meetings and/or travel from Roche and AstraZeneca; and participation on a data safety monitoring board or advisory board for AstraZeneca, all in the 36 months prior to manuscript submission. G. Hardavella declares no competing interests. M. Hauptmann declares no competing interests. E. Jakobsen declares no competing interests. D. Jovanovic declares payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Merck Sharp & Dohme, Roche, Boehringer Ingelheim, WCBIP 2020 and AstraZeneca; payment for expert testimony relating to the health effects of air pollution from SO2 released by Serbia Zijin Copper mining and smelting complex and the two biggest Serbian power plants, all in the 36 months prior to manuscript submission; and is a member of the editorial boards of the Journal of Thoracic Disease and the AME Surgical Journal, and a committee member of the National Ecological Association (NEA), Serbia. P. Knaut declares no competing interests. G. Massard declares a speaker's fee from Pneumo Update Europe, in the 36 months prior to manuscript submission. J. McPhelim declares advisory board payments from AstraZeneca, Janssen-Cilag and Bristol Myers Squibb, all in the 36 months prior to manuscript submission. A-P. Meert declares no competing interests. R. Milroy declares no competing interests. R. Muhr declares no competing interests. L. Mutti declares no competing interests. M. Paesmans declares no competing interests. P. Powell is an employee of the European Lung Foundation. P.M. Putora declares research grants to their institution from AstraZeneca, Takeda and Bayer; and a speaker's fee from Janssen-Cilag, all in the 36 months prior to manuscript submission. J. Rawlinson declares travel/accommodation support from the BTOG to attend the annual meeting in Dublin as patient advocate/steering committee member; travel/accommodation support from the European Respiratory Society to attend a screening meeting in Barcelona (patient representative) and European Lung Foundation patient event at the European Respiratory Society Congress Madrid 2019; travel/accommodation support from the NCRI to attend a conference in Glasgow (consumer member); travel/accommodation support from the EORTC to attend the Patient Days event as a speaker and patient panel member; and has been a Non-Executive Director (lay member) at Sandwell and West Birmingham Clinical Commissioning Group, UK. A.L. Rich declares no competing interests. D. Rigau is a methodologist for the European Respiratory Society. D. de Ruysscher declares grants to their institution from AstraZeneca and BeiGene; payment to their institution for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca; and payment to their institution for participation on an advisory board from AstraZeneca, all in the 36 months prior to manuscript submission. J-P. Sculier declares no competing interests. A. Schepereel declares a research grant to their institution from Bristol Myers Squibb; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, Bristol Myers Squibb and Leo Pharma; support for attending meetings and/or travel from AstraZeneca, Bristol Myers Squibb, Merck Sharp & Dohme and Roche; and payment for participation on a data safety monitoring board or advisory board from AstraZeneca, Bristol Myers Squibb and Merck Sharp & Dohme, all in the 36 months prior to manuscript submission. D. Subotic declares no competing interests. P. Van Schil declares consulting fees paid to their institution by AstraZeneca and Merck Sharp & Dohme; payment to their institution for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca; and travel expenses related to participation in data safety monitoring or advisory boards for the LungART Trial and the Pearls Trial, all in the 36 months prior to manuscript submission; and is the President-elect of the International Association for the Study of Lung Cancer and the Treasurer of the Belgian Association for Cardio-Thoracic Surgery. T. Tonia is a methodologist for the European Respiratory Society. C. Williams is an employee of the European Lung Foundation. T. Berghmans declares consulting fees from InhaTarget; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Janssen; and participation on a data safety monitoring board or advisory board for Janssen and Roche, all in the 36 months prior to manuscript submission.