Implementation of lung cancer screening in Europe:challenges and potential solutions: summary of a multidisciplinary roundtable discussion

Recent randomised trials on screening with low-dose CT have shown important reductions in lung cancer (LC) mortality and have triggered international efforts to implement LC screening. Detection rates of stage I LC with volume CT approaching 70% have been demonstrated. In April 2019 'ESMO Open - Cancer Horizons' convened a roundtable discussion on the challenges and potential solutions regarding the implementation of LC screening in Europe. The expert panel reviewed the current evidence for LC screening with low-dose CT and discussed the next steps, which are covered in this article. The panel concluded that national health policy groups in Europe should start to implement CT screening as adequate evidence is available. It was recognised that there are opportunities to improve the screening process through 'Implementation Research Programmes'

Implementation of lung cancer screening in Europe: Challenges and potential solutions: Summary of a multidisciplinary roundtable discussion

Recent randomised trials on screening with low-dose CT have shown important reductions in lung cancer (LC) mortality and have triggered international efforts to implement LC screening. Detection rates of stage I LC with volume CT approaching 70% have been demonstrated. In April 2019 'ESMO Open-Cancer Horizons' convened a roundtable discussion on the challenges and potential solutions regarding the implementation of LC screening in Europe. The expert panel reviewed the current evidence for LC screening with low-dose CT and discussed the next steps, which are covered in this article. The panel concluded that national health policy groups in Europe should start to implement CT screening as adequate evidence is available. It was recognised that there are opportunities to improve the screening process through 'Implementation Research Programmes'

Rethinking Polanyi’s concept of tacit knowledge: From personal knowing to imagined institutions

Half a century after Michael Polanyi conceptualised ‘the tacit component’ in personal knowing, management studies has reinvented ‘tacit knowledge’—albeit in ways that squander the advantages of Polanyi’s insights and ignore his faith in ‘spiritual reality’. While tacit knowing challenged the absurdities of sheer objectivity, expressed in a ‘perfect language’, it fused rational knowing, based on personal experience, with mystical speculation about an un-experienced ‘external reality’. Faith alone saved Polanyi’s model from solipsism. But Ernst von Glasersfeld’s radical constructivism provides scope to rethink personal tacit knowing with regard to ‘other people’ and the intersubjectively viable construction of ‘experiential reality’. By separating tacit knowing from Polanyi’s metaphysical realism and drawing on Benedict Anderson’s concept of ‘imagined communities’, it is possible to conceptualise ‘imagined institutions’ as the tacit dimension of power that shapes human interaction. Whereas Douglass North claimed institutions could be reduced to rules, imagined institutions are known in ways we cannot tell

The Genesis of 20th century philosophy. : The evolution of thought from Copernicus to the present

New Yorkxi, 418 p.; 20 cm

Book Review Editor

by R. T. Alle

European position statement on lung cancer screening.

Lung cancer screening with low-dose CT can save lives. This European Union (EU) position statement presents the available evidence and the major issues that need to be addressed to ensure the successful implementation of low-dose CT lung cancer screening in Europe. This statement identified specific actions required by the European lung cancer screening community to adopt before the implementation of low-dose CT lung cancer screening. This position statement recommends the following actions: a risk stratification approach should be used for future lung cancer low-dose CT programmes; that individuals who enter screening programmes should be provided with information on the benefits and harms of screening, and smoking cessation should be offered to all current smokers; that management of detected solid nodules should use semi-automatically measured volume and volume-doubling time; that national quality assurance boards should be set up to oversee technical standards; that a lung nodule management pathway should be established and incorporated into clinical practice with a tailored screening approach; that non-calcified baseline lung nodules greater than 300 mm3, and new lung nodules greater than 200 mm3, should be managed in multidisciplinary teams according to this EU position statement recommendations to ensure that patients receive the most appropriate treatment; and planning for implementation of low-dose CT screening should start throughout Europe as soon as possible. European countries need to set a timeline for implementing lung cancer screening