Comparable times to lung cancer diagnosis with virtual and in-person care: An observational study during the COVID-19 pandemic.

Abstract

IntroductionTimely diagnosis of lung cancer is critical for improving health outcomes. During the COVID-19 pandemic, the use of virtual healthcare increased to facilitate distancing, accessibility and convenience. Despite these perceived benefits, the impact of virtual care on timeliness and quality within the lung cancer diagnostic pathway remains unclear.ObjectiveTo evaluate differences in time to lung cancer diagnosis and health outcomes between virtual and in-person care models.MethodsWe conducted a retrospective cohort study of all patients referred to a Lung Diagnostic Assessment Program (LDAP) at a large academic hospital in Ontario, Canada in 2022. Patients were grouped based on whether their intake visit was conducted virtually or in-person. The primary outcome was time from referral to tissue diagnosis. Secondary outcomes include time from referral to initial consultation and biopsy, time to complete all investigations, hospitalizations, cancelled procedures and death during the diagnostic interval. Outcomes were compared between groups.ResultsAcross 265 clinical encounters (120 virtual, 145 in-person) the median time from referral to tissue diagnosis was 28.5 days [IQR = 18-45] for virtual and 28 days [IQR = 20-51] for in-person care (p = .55). Times to consultation, diagnostic biopsy and completion of diagnostic testing were similar between groups. Hospitalizations, procedure cancellation, and mortality did not differ between care delivery models.DiscussionVirtual care demonstrated timeliness and health outcomes comparable to in-person care, supporting its role as a feasible alternative in the lung cancer diagnostic pathway.