Calculator - MagArray

When choosing a strategy for evaluating patients with lung nodules, clinicians should consider both the probability that the nodule is malignant and the advantages and disadvantages of management strategies. The VA Clinical Model has been validated, is available at no charge, and requires only four simple inputs – smoking status, years since quitting, age, and nodule size in mm or cm. The score generated will place your patient into a risk group (low, intermediate, high) that corresponds to the probability that the nodule is malignant.

VA Clinical Model^*

Directions For Use^†

Fill in the fields in the calculator based on the following key predictors of malignancy:

Enter patient’s smoking history as Current, Former, or Never

Enter patient’s age in years

Enter patient’s nodule size units (cm or mm)

Enter the size of the patient’s largest nodule “cm” or “mm” based on answer above

Enter years since patient stopped smoking

Patient’s pCA (pre-test probability of malignancy)

Low Risk pCA <5% Consider REVEAL if your patient is uncomfortable with adopting a strategy of surveillance when told that their lung nodule is indeterminate (i.e. not clearly benign).

Intermediate Risk pCA 5-65% Consider REVEAL to minimize the harms of invasively evaluating patients (serial CT scans, non-surgical biopsy, and surgical diagnosis) with benign disease, or to encourage further evaluation to enable earlier diagnosis of malignant nodules.

High Risk pCA >65% Consider REVEAL if your patient is not a suitable candidate for surgery or if they are risk averse about undergoing surgery.

1. MacMahon H, Austin JH, Gamsu G, et al. Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society. Radiology 2005;237(2):395–400

2. Radiology: Volume 284: Number 1—July 2017, radiology.rsna.org 228-243

3. Gould M, et al. Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer? CHEST 2013, e93S -e120s

^*with permission from the author, Gould, CHEST, 2007, page 4

^†All information produced by the VA Clinical Model is provided for educational purposes only. This information should not be used for the diagnosis or treatment of any health problem or disease. This information is not intended to replace clinical judgement or guide individual patient care in any manner.

When choosing a strategy for evaluating patients with lung nodules, clinicians should consider both the probability that the nodule is malignant and the advantages and disadvantages of management strategies. The Mayo Clinical Model has been validated, is available at no charge, and requires only six simple inputs – smoking status, age, nodule size in mm or cm, history of cancer, nodule spiculation, and the location of the nodule. The score generated will place your patient into a risk group (low, intermediate, high) that corresponds to the probability that the nodule is malignant.

Mayo Clinical Model^*

Directions For Use^†

Fill in the fields in the calculator based on the following key predictors of malignancy:

Enter patient’s smoking history as Current, Former, or Never

Enter patient’s age in years

Enter patient’s nodule size units (cm or mm)

Enter the size of the patient’s largest nodule “cm” or “mm” based on answer above

Enter patient’s cancer history - Yes or No

Enter nodule appearreance: spiculated - Yes or No

Enter the location of patient’s largest nodule as Upper Lobe or Lower Lobe

Patient’s pCA (pre-test probability of malignancy)

Low Risk pCA <5% Consider REVEAL if your patient is uncomfortable with adopting a strategy of surveillance when told that their lung nodule is indeterminate (i.e. not clearly benign).

High Risk pCA >65% Consider REVEAL if your patient is not a suitable candidate for surgery or if they are risk averse about undergoing surgery.

1. MacMahon H, Austin JH, Gamsu G, et al. Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society. Radiology 2005;237(2):395–400

2. Radiology: Volume 284: Number 1—July 2017, radiology.rsna.org 228-243

3. Gould M, et al. Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer? CHEST 2013, e93S -e120s

^*with permission from the author, Swensen, Arch Intern Med. 1997;157:849-855

VA Clinical Model*

Directions For Use†

Mayo Clinical Model*

Directions For Use†

VA Clinical Model^*

Directions For Use^†

Mayo Clinical Model^*

Directions For Use^†