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IntroductionThe Pulmonary Rehabilitation Services Accreditation Scheme (PRSAS), hosted by the Royal College of Physicians uses a framework set out by the British Standard Institution’s specification for accreditation of clinical services, to measure PR services in line with British Thoracic Society national guidance. The aim of this study is to determine the impact of accreditation on key performance indicators (KPI).MethodsThe National Respiratory Audit Programme 2022–2023 Breathing Well report data was used. This provides service level data alongside KPI, including time to receipt of PR, completion of a discharge assessment, written discharge plan, and performing a practice 6 minute or Incremental Shuttle Walking Test (6MWT/ISWT). Services were grouped by accreditation status as of January 2025. Data was analysed using a one-way ANOVA. For accredited services, comparisons of KPI from the 2019 PR clinical audit report and 2022–2023 Breathing Well report were made using a paired t-test.Results176 services were included in the analysis (24(13%) accredited, 18(10%) undergoing assessment, 34(18%) not registered and 100(54%) registered only). There were statistically significant differences in number of patients enrolled per service in favour of those accredited (mean[SD] 143[110] compared to those not registered (71[83]) and registered only services (85[70]), p<0.01. The mean[SD] days from assessment to commencing PR in stable COPD was 108[82] accredited services, 126[62] undergoing assessment, 130[109] registered only and 164[118] not registered, however this was not statistically significant. There was no statistical difference for other KPI (table 1).There was a statistically significant improvement in percentage of people enrolled from the 2019 to 2022/2023 audit in accredited services with a mean[SD] improvement of 16[31]%, p=0.03. Percentage of patients completing a practice 6MWT changed from 60[41] to 86[12] (n=4) and 87[26] to 80[32] in the ISWT (n=12), though this was not statistically significant.Abstract P35 Table 1The mean[SD] percentage of patients achieving the key performance indicators. N= number of servicesConclusionAccredited services enrol a larger number of patients into PR. There is signal in improved waiting times, written discharge plans and practice 6MWT in accredited services however this did not reach statistical significance.

IntroductionLung neuroendocrine neoplasms (NENs) are a rare group of lung cancers that often express somatostatin receptors (SSTR2&5), with potential of diagnostic and therapeutic radiolabelled somatostatin analogues (SSAs). 99mTc-EDDA/HYNIC-TOC (Tektrotyd) is a readily available SPECT-based radiolabelled SSA that offers a cost-effective alternative with improved count rate and image resolution compared to earlier SSTR imaging agents. In lung NENs, we aim to evaluate the novel use of Tektrotyd alongside conventional assessment.MethodsSingle-centre retrospective analysis was conducted on 38 patients with 41 lung lesions (n=41) who underwent Tektrotyd SPECT between March 2012 and April 2023 for suspected lung NENs. Diagnostic performance metrics (sensitivity, specificity, PPV, NPV) and area under the ROC curve (AUC) were calculated and compared across Tektrotyd SPECT (n=41), 18F-FDG PET/CT (n=27), and serum Chromogranin A (CgA) (n=23). ROC analysis using Krenning scores (KS), SUVmax, and CgA levels as continuous predictors. Final diagnoses and outcomes were reviewed.ResultsAmong 41 diagnoses, 23 were lung NENs, all confirmed with histology. 22 of them were Tektrotyd-positive (KS ≥1): typical carcinoid (n=16), atypical carcinoid (n=1), metastatic carcinoid (n=4; 2 typical carcinoid, 1 large cell neuroendocrine carcinoma, 1 pancreatic carcinoid), and DIPNECH (n=1). 1 Tektrotyd-negative (KS=0): typical carcinoid (n=1). In the 18 cases without lung NENs, there were 6 false positive and 12 true negative Tektrotyd SPECT results. Diagnostic performance metrics and ROC analyses for Tektrotyd SPECT, 18F-FDG PET/CT, and serum CgA are summarised in the figure 1. Most confirmed lung NENs (n=17) underwent surgical resection; others received SSA therapy, Everolimus, surveillance, or supportive chemotherapy.Abstract P172 Figure 1Diagnostic performance and ROC analysis for Tektrotyd SPECT, 18F-FDG PET/CT, and serum CgA[Image Omitted. See PDF.]ConclusionsTektrotyd SPECT demonstrated superior diagnostic accuracy for lung NENs compared to 18F-FDG PET/CT and CgA testing, with particularly high sensitivity and AUC. FDG uptake often occurs in the more undifferentiated lung NENs. Hence this supports the utility of Tektrotyd SPECT as a reliable and cost-effective imaging modality for the initial evaluation and staging of suspected lung NENs. If available Ga 69 DOTATE PET/CT would of use in a similar approach. The moderate specificity and PPV suggests that positive Tektrotyd results should be reviewed in the clinical context supported by additional biomarkers and ideally confirmed by histopathology.

Abstract Background and aims Mood screening, swallow screening, Multidisciplinary team (“MDT”) review and stroke unit (“SU”) admission have been shown individually to improve outcomes in stroke care. This review aimed to assess the consistency and correlation of completing these specific indicators of routine stroke care across all stroke unit-equipped hospitals in the republic of Ireland. Methods Data regarding specific performance indicators of routine stroke care was analysed from the Irish National audit of stroke for the year 2024. Data from 24 hospitals across the Republic of Ireland with stroke units was included. Specific performance indicators analysed including mood screening, swallow screening within 4 hours, MDT assessment and SU admission in each centre were analysed and correlated in pairs using Excel formulae. Results The highest correlation was seen between mood screening and MDT assessment at 0.434885 and a p value of 0.03. Conclusions This analysis shows that achievement of single specific performance indicators relating to stroke admission care in Irish stroke centres does not necessarily predict achievement of others. Whilst the specific performance indicators analysed have individually been shown to improve outcomes in stroke care, efforts should be implemented to achieve all specific performance indicators as part of routine post-admission stroke care in Ireland. Conflict of interest Nil Table 1 - belongs to Results

Background: Improving global surgical capacity and quality requires data-driven, evidence-based interventions and collaborations. Low-resource settings, where disparities in access to and quality of surgical treatment led to excess mortality, have few surgical data, and most of the available data come from developed nations with little involvement from the data owner countries. The purpose of this study was to implement a perioperative registry in Ethiopia to generate continuous surgical data and examine whether this would help address African perioperative research priorities. Ethiopia is the second-most populous country in Sub-Saharan Africa and the headquarters of the African Union. Methods: A south-south collaboration supported the implementation of a context-specific, clinician-led, multicentre real-time perioperative registry in Ethiopia. Data from perioperative care, including the Ethiopian Ministry of Health's national Saving Lives Through Safe Surgery initiative was linked to real-time dashboards, which provided clinicians and administrators with reports on service utilization, surgical access, and national surgical performance indicators. A total of 285 beds were sourced from 4 hospitals in the Amhara, Southern Nations, Nationalities, and Peoples regions, and Addis Ababa. Results: A total of 1748 consecutive surgical cases were recorded from April 2019 to April 2020, and compliance with the World Health Organization's Surgical Safety Checklist was 1595 (92.1%). Thirty-three patients (3.1%) experienced adverse events during anesthesia, and 21 (2.0%) developed surgical site infections. Conclusion: The collaboration has successfully implemented a multicentre surgical registry that can assess key performance indicators for surgery and evaluate perioperative outcomes of patients. This can be scaled and is capable of interconnecting different African countries and implementing a minimal data set registry.