The flow chart of the study design is shown in Figure 1.After enrollment, participants are
randomly assigned into two groups: the IoT group and the routine management group. For both
groups, participants are gathered basic information (age, sex, smoking and smoking status,
family history of cancer, family history of lung disease,Other malignant tumor history, drug
using history and its effect during a fever). For the IoT group, "three plus two type
pulmonary nodule diagnosis" which professor Bai put forward is carried out on participants:
three basic steps: ① gather information: smoking history, tumor personal and family history,
copd history, etc.; ② noninvasive examination: tumor markers, lung function and chest
low-dose CT thin layer; ③ information mining in-depth:through the software for
three-dimensional reconstruction of pulmonary nodules, depth excavation, accurate calculation
of the density of the volume, assessment of the surrounding and infiltration of lung nodules
and related vascular growth status; two solutions: ① Pathological diagnosis in highly
suspected participants: fiber bronchoscope, ultrasonic bronchoscope, thoracoscope and CT
guided percutaneous lung biopsy, etc; ② Close scientific follow-up to the person who can not
be qualitative: doctors follow up and manage participants scientifically in accordance with
the follow-up management tables through the Internet of things platform (Researchkit). The
routine management group are completely managed by investigators' personal experience.
Follow-up Researchkit APP based on the android phone system and IOS system is installed in
the participant's cellphone for free and all participant are trained to use the software.
They are allowed to practice until accurate data submission and collection are ascertained.
At the same time, an APP instruction is also provided, with one engineer ready for
consultation in case of any technical problems. The following measures are carried out via
the Internet platform: ① collect the basic information of the subjects, suggest the date of
follow-up according to the the subjects' nodule situation; ② health education is pushed to
the subjects' mobile terminal to help them carry out self health management; ③ subjects are
asked to report their physical conditions once a month via Researchkit APP; ④ communication
with medical staff during work hours is available remotely through the mobile device.
Participant are allowed to make unscheduled clinic visits and emergency visits as necessary.
The study period is 5 years. The outcomes will be recorded and the superiority of "iot three
plus two diagnosis method" in the management of pulmonary nodules will be evaluated.