Public health impact of a diagnostic improvement intervention supported by Rapid On-Site Evaluation (ROSE) in thoracic CT-guided biopsies: a pre-post study

Background. Lung cancer is the leading cause of cancer death worldwide and was the most commonly diagnosed cancer in 2022. The Rapid On-Site Evaluation (ROSE) technique allows immediate evaluation of samples collected during needle aspiration and needle biopsy procedures, improving diagnostic accuracy and reducing the need for repeated procedures.

Study Design. A pre-post study evaluated the health benefits for patients and improved healthcare costs with ROSE diagnostic support from a public health perspective.

Methods. We compared two groups of patients who underwent TC-guided transthoracic needle aspiration/biopsy from March 2017 to March 2022. In the first group (pre-ROSE) the procedures were performed without the support of ROSE, while in the second group (post-ROSE) the pathologist assisted the radiologist in all cases. The diagnostic advantages, the economic-organizational impact of the procedure, and the related benefits for patients were analyzed.

Results. The pre-ROSE group comprised 97 patients, and the post-ROSE group comprised 67. In the group receiving ROSE diagnostic support, the rate of inadequate diagnostic tests requiring repetition decreased from 29.9% to 9.0% (p = 0.001). This saved time for the radiologist, pathologist, nurse, radiology technician, laboratory technician, and support staff, freeing up diagnostic slots that could be used to reduce waiting lists and improve the quality of patient service.

Conclusions. ROSE support has improved diagnostic efficacy and sample quality, reducing repeat testing and associated costs. This leads to better management of healthcare resources, reduced waiting times, and more accurate diagnoses, improving the quality of patient care and bringing public health benefits.