Clinical calculator summary
Lung Nodule Malignancy Risk Panel
Clinical calculator summary
Lung Nodule Malignancy Risk Panel
This panel is a neutral comparison workspace for three separately verified pulmonary-nodule models.
Evidence-based context for fast calculator use
- Purpose:
- Displays independent Brock, Mayo, and Herder pulmonary-nodule model results with model-specific applicability; it does not create a combined risk estimate.
- Population:
- patients whose clinical question requires the component models displayed in the combined panel
- Factors:
- Age, Sex for Brock, Smoking history for Mayo/Herder, Cancer history for Mayo/Herder, Family history of lung cancer for Brock, Emphysema on CT for Brock, Nodule diameter, Nodule location
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Lung Nodule Malignancy Risk Panel
years
mm
Clinical Context & Background
This panel is a neutral comparison workspace for three separately verified pulmonary-nodule models. It never takes the maximum, averages probabilities, or creates a combined category.
Brock is screening-derived and can address multiple, solid, part-solid, and ground-glass nodules within its verified contract. Mayo is a pre-PET model for an eligible solitary solid 4-30 mm indeterminate nodule. Herder is a post-PET adjustment for the same eligible solitary-solid context and is unavailable when PET was not performed.
Different results can reflect different populations and timing. Agreement or discordance is not an error, and a model must be chosen for clinical applicability rather than by selecting the highest probability.
Formula Logic
INDEPENDENT COMPONENTS - NO COMBINED SCORE
[Brock (PanCan)]
Full model with spiculation (PanCan Model 2b):
Transformed diameter = ((diameter / 10)^-0.5) - 1.58113883
Logit = -6.78917
+ (0.0286687 * (age - 62))
+ (0.6010727 * female)
+ (0.2961090 * family history)
+ (0.2953112 * emphysema)
- (5.3854840 * transformed diameter)
- (0.1276173 * ground-glass nodule)
+ (0.3769578 * part-solid nodule)
+ (0.6581383 * upper-lobe location)
+ (0.7729335 * spiculation)
- (0.0824156 * (nodule count - 4))
Probability = 100 / (1 + e^-Logit)
[Mayo Clinic 1997]
Swensen 1997 Mayo Clinic model:
Logit = -6.8272
+ (0.0391 * age in years)
+ (0.7917 * current/former smoker)
+ (1.3388 * extrathoracic cancer diagnosed >5 years ago)
+ (0.1274 * nodule diameter in mm)
+ (1.0407 * spiculation)
+ (0.7838 * upper-lobe location)
Probability (%) = 100 / (1 + exp(-Logit))
Later ACCP probability bands (not part of the 1997 equation): <5% low, 5-65% intermediate, >65% high.
[Herder 2005]
Herder et al. 2005 PET-adjusted pulmonary nodule model:
First calculate the full-precision Swensen/Mayo malignancy probability as a fraction from 0 to 1.
Herder logit = -4.739
+ (3.691 * full-precision Mayo probability fraction)
+ (2.322 * faint FDG uptake)
+ (4.617 * moderate FDG uptake)
+ (4.771 * intense FDG uptake)
Absent uptake is the reference category (coefficient 0). Exactly one PET category is used.
Probability (%) = 100 / (1 + exp(-Herder logit)).
Later BTS bands: <10% low, 10-70% intermediate, >70% high. Exact 10% and 70% are intermediate.
The panel does not calculate a maximum, average, combined probability, combined category, or preferred model.
References: McWilliams et al. 2013 (Brock/PanCan); Swensen et al. 1997 (Mayo); Herder et al. 2005; BTS pulmonary nodule guideline 2015.Reference Data
| Model | Raw Category | Probability | Applicability |
|---|---|---|---|
| Brock | Very Low | <1% | Screening-derived; verified Brock contract |
| Brock | Low/Intermediate | 1-10% | Exact 1% and 10% included |
| Brock | High | >10% | Independent component result |
| --- | --- | --- | --- |
| Mayo | Low | <5% | Eligible solitary solid 4-30 mm; pre-PET |
| Mayo | Intermediate | 5-65% | Later ACCP overlay; exact bounds included |
| Mayo | High | >65% | Independent component result |
| --- | --- | --- | --- |
| Herder | Low | <10% | Eligible solitary solid 4-30 mm after PET |
| Herder | Intermediate | 10-70% | Later BTS overlay; exact bounds included |
| Herder | High | >70% | Independent component result |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use Lung Nodule Malignancy Risk Panel when displays independent Brock, Mayo, and Herder pulmonary-nodule model results with model-specific applicability; it does not create a combined risk estimate.
- Confirm that the patient, diagnosis, disease phase, and available inputs match the cited model before calculation.
How To Interpret
- Interpret the displayed result using the calculator-specific formula and reference table, spanning Brock through Herder.
- A boundary result should prompt input verification and clinical review rather than false precision.
What To Do Next
- Review every component result separately; if models disagree, verify inputs and follow the more cautious disease-specific pathway rather than averaging scores.
- Document the inputs, result, timing, and clinical context so the assessment can be reproduced.
Limitations
- A panel improves comparison but does not make component models interchangeable or create a new validated composite score.
- The result supports clinician judgment and does not independently determine treatment.
Validated Population
patients whose clinical question requires the component models displayed in the combined panel
How to apply this result
For a representative case, verify Age, Sex for Brock, Smoking history for Mayo/Herder, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed cases passed through the visible production controls across a complete age-first submission, the part-solid applicability branch, and an intense-uptake PET branch.
- Age remained 65 before and after every calculation; Brock, Mayo, and Herder matched their independent expected results and applicability states without a combined score.
- No stale or non-actionable control, unexpected N/A, literal undefined/null value, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/panel-lung-nodule-2026-08-03.json.
: Local browser remediation verified; production retest pending
- Ten source-backed cases passed through visible controls on the corrected local route across 11 submissions.
- Age was entered first in every case and remained visible before and after calculation while all later radio, number, and dependent PET controls were completed.
- Brock, Mayo, and Herder outputs and applicability states remained independent, and reset/repeat cleared stale PET and result state. No panel-specific formula change was required beyond the shared hydration repair. The original production findings remain open until deployment and public revalidation.
Case-level local remediation evidence is retained in validation/browser-production/panel-lung-nodule.local-remediation.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 0 visible submissions.
- Overall browser status: failed-stale-input-and-console. critical: When age was entered first after production load and the remaining controls were completed, the visible age value disappeared before submission; Calculate then returned `This field is required` instead of panel results. | medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/panel-lung-nodule.json.
: Exact input guidance for unavailable component results
- Brock, Mayo, and Herder skipped or invalid explanations now use "Please review" and name the exact visible entries in parentheses.
- Positron-emission tomography is written out in corrective prose while the parenthetical reference preserves the exact form label.
- No regression coefficient, population rule, risk band, or component-isolation behavior changed.
All 462 existing panel assertions pass; current report remains applicable.
: Input-quality and partial-completion verification
- Added exact required and component-usage metadata for all thirteen fields; Brock-only, Mayo/Herder history, and Herder PET groups are visibly optional at panel level.
- An entirely blank model-specific group now reports Skipped / Missing Input, while a partially completed or malformed group remains Invalid Input; valid siblings are preserved.
- 462/462 orchestration assertions passed, including eight new partial-completion, metadata, and hidden-dependent reset contracts.
: Full validation test
- 454/454 independent panel-orchestration checks passed with zero child-parity difference; Brock 45/45, Mayo 259/259, and Herder 591/591 regressions also passed.
- This verifies implementation and orchestration only; it is not prospective clinical validation of the component models.
: Correction history
- Removed the unsupported maximum of Mayo, Brock, and Herder probabilities and removed the combined risk category.
- Added independent child applicability so unavailable, inapplicable, or invalid data for one model cannot suppress another valid model.
- Preserved model-specific full-precision probabilities, categories, input snapshots, warnings, rows, traces, copy text, and saved results without parsing display strings.
: Herder component revalidated
- 64/64 valid standalone-to-panel parity checks and 24/24 panel invalid/applicability checks passed using the shared raw Herder engine.
- The panel maximum-risk synthesis, discordance presentation, and overall management mapping remain in review; the panel is not implementation verified.
: Mayo component revalidated
- 96/96 Mayo component checks passed for raw-result parity, exact field mapping, cutoffs, and out-of-scope propagation.
- Herder and the maximum-risk synthesis remain in review; the panel is not implementation verified.
: Brock component revalidated
- Applied the shared Brock age range of 18-100 years and nodule-size range of 1-30 mm.
- The complete panel remains in review until Mayo, Herder, and synthesis verification are finished.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
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Frequently Asked Questions
When should Lung Nodule Malignancy Risk Panel be used?
Use it for patients whose clinical question requires the component models displayed in the combined panel when all required inputs and the intended clinical setting are confirmed.
Can Lung Nodule Malignancy Risk Panel determine treatment by itself?
No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.
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