Table 2.

Inclusion and exclusion of diagnostic indicators at each Delphi round for lung cancer

Diagnostic indicator	Round 1 (mean score for importance)	Round 2 (mean rank score)	Round 3 (crucial)
Key risk factor
Smoking status^a	5.00	1.13	Y
Occupational exposure^a	4.54	4.50	Y
Age^a	4.33	3.31	Y
Second attendance with the same symptom^a	4.25	8.25	Y
History of chronic obstructive pulmonary disease^a	4.13	6.81	Y
Second-hand smoke exposure^a	4.04	7.00	Y
Socioeconomic status	3.71	7.19	N^b
Family history (first-degree relative)^a	3.58	9.56	Y
Last consultation with a GP >6 months ago	3.46	12.88^b
History of idiopathic pulmonary fibrosis	3.42	12.75^b
History of tuberculosis	3.33	13.81^b
Sex	3.25	11.19^b
Alcohol intake	3.17	11.75^b
Ethnicity^b	2.79^b
Last consultation with a GP >5 years ago^c		10.38	N^b
Patient thinks they may have lung cancer^a,^c		11.13	Y
Patient attends with an adult family member^c		15.75^b
Localisation of pain^c		12.63^b
Reduced exercise tolerance^a,^c			Y

Symptom
Haemoptysisa	4.96	1.25	Y
Unintentional loss of weight reported by patient^a	4.79	4.44	Y
Symptom duration^a,^d	4.25	6.19	Y
Cough^a	4.17	3.00	Y
Hoarseness^a	4.13	6.06	Y
Dyspnoea^a	4.00	4.38	Y
Chest pain^a	3.79	6.69	Y
Bone pain	3.92	9.88^b
Loss of appetite	3.88	7.88^b
Back pain	3.88	10.56^b
Fatigue	3.88	8.81^b
Shoulder pain	3.75	8.88^b

Sign
Cachexia^a	4.71	3.94	Y
Pleural mass^a	4.67
Pleural effusion^a	4.67	3.69	Y
Superior vena cava obstruction^a	4.58	3.31	Y
Objective weight loss^a	4.54	4.5	Y
Lymphadenopathy^a	4.25	5.94	Y
Stridor^a	4.21	6.00	Y
Finger clubbing	4.00	7.31^b
Horner's syndrome^a,^c		6.50	Y

Test
Abnormal chest X-ray^a	4.79	1.06	Y
Abnormal sputum cytology	4.13	3.75	N^b
Anaemia	3.71	3.69	N^b
Raised erythrocyte sedimentation rate	3.75	4.63^b
Raised C-reactive protein	3.5	5.56^b
Abnormal spirometry	3.33	6.06^b
Thrombocytosis	3.25	7.31^b
Hypercalcaemia^c		6.81^b
Disturbed liver function tests^c		6.13^b

↵a Included in round 3.
↵b Excluded in round 2.
↵c Added by participants in round 1.
↵d Refers to whether the symptom was present for a long period of time as opposed to only a short period.