National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Cancer (17)
- (-) Cancer: Lung Cancer (23)
- Case Study (3)
- Clinician-Patient Communication (1)
- Comparative Effectiveness (1)
- COVID-19 (1)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Elderly (6)
- Evidence-Based Practice (5)
- Guidelines (3)
- Healthcare Costs (3)
- Healthcare Delivery (1)
- Healthcare Utilization (2)
- Imaging (5)
- Implementation (1)
- Lifestyle Changes (1)
- Medicare (2)
- Medication (2)
- Mortality (2)
- Nursing Homes (1)
- Opioids (1)
- Organizational Change (1)
- Outcomes (4)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (1)
- Prevention (3)
- Quality Improvement (1)
- Quality of Life (2)
- Racial and Ethnic Minorities (2)
- Respiratory Conditions (1)
- Risk (2)
- Screening (7)
- Shared Decision Making (1)
- Surgery (5)
- Teams (1)
- Tobacco Use (1)
- Treatments (2)
- U.S. Preventive Services Task Force (USPSTF) (4)
- Vulnerable Populations (1)
- Women (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 23 of 23 Research Studies DisplayedGerber DE, Hamann HA, Dorsey O
Clinician variation in ordering and completion of low-dose computed tomography for lung cancer screening in a safety-net medical system.
Less than 5% of eligible individuals in the United States undergo lung cancer screening. Variation in clinicians' participation in lung cancer screening has not been determined. In this study the investigators examined medical providers who ordered ≥ 1 low-dose computed tomography (LDCT) for lung cancer screening from February 2017 through February 2019 in an integrated safety-net healthcare system. The investigators concluded that in an integrated safety-net healthcare system, most adult primary care providers ordered LDCT.
AHRQ-funded; HS022418.
Citation: Gerber DE, Hamann HA, Dorsey O .
Clinician variation in ordering and completion of low-dose computed tomography for lung cancer screening in a safety-net medical system.
Clin Lung Cancer 2021 Jul;22(4):e612-e20. doi: 10.1016/j.cllc.2020.12.001..
Keywords: Imaging, Cancer: Lung Cancer, Cancer
Shipe ME, Haddad DN, Deppen SA
Modeling the impact of delaying the diagnosis of non-small cell lung cancer during COVID-19
The novel coronavirus (COVID-19) pandemic has led surgical societies to recommend delaying diagnosis and treatment of suspected lung cancer for lesions less than 2 cm. The COVID-19 infection rate at which immediate operative risk exceeds benefit is unknown. Delaying diagnosis can lead to disease progression, but the impact of this delay on mortality is unknown. In this study, the investigators sought to model immediate versus delayed surgical resection in a suspicious lung nodule less than 2 cm.
AHRQ-funded; HS026122.
Citation: Shipe ME, Haddad DN, Deppen SA .
Modeling the impact of delaying the diagnosis of non-small cell lung cancer during COVID-19
Ann Thorac Surg 2021 Jul;112(1):248-54. doi: 10.1016/j.athoracsur.2020.08.025..
Keywords: COVID-19, Cancer: Lung Cancer, Cancer, Diagnostic Safety and Quality, Case Study, Risk
Tracer H, Pierre J
AHRQ Author: Tracer H
Screening for lung cancer.
This paper is part of the “Putting Prevention into Practice” series. It provides an evidence-based case study related to lung cancer screening. Questions and answers related to the case are included.
AHRQ-authored.
Citation: Tracer H, Pierre J .
Screening for lung cancer.
Am Fam Physician 2021 Jul 1;104(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Lung Cancer, Cancer, Screening, Prevention, Case Study, Evidence-Based Practice
Medbery RL, Fernandez FG, Kosinski AS
Costs associated with lobectomy for lung cancer: an analysis merging STS and Medicare data.
Researchers sought to identify underlying case mix factors that contribute to variability of 90-day costs of lobectomy for early-stage lung cancer. Using the Society of Thoracic Surgeons General Thoracic Surgery Database, they found that lobectomy is associated with substantial variability of episode-of-care costs. Variability is driven by patient demographic and clinical factors, hospital characteristics, and the occurrence and severity of complications.
AHRQ-funded; R01 HS022279.
Citation: Medbery RL, Fernandez FG, Kosinski AS .
Costs associated with lobectomy for lung cancer: an analysis merging STS and Medicare data.
Ann Thorac Surg 2021 Jun;111(6):1781-90. doi: 10.1016/j.athoracsur.2020.08.073..
Keywords: Cancer: Lung Cancer, Cancer, Healthcare Costs, Surgery, Elderly, Medicare
Cowper PA, Feng L, Kosinski AS
Initial and longitudinal cost of surgical resection for lung cancer.
This study looked at the 4-year longitudinal cost of surgical resection of non-small cell lung cancer (NSCLC). The study describes initial and 4-year resource use and cost for NSCLC patients aged 65 years of age or older who were treated surgically from 2008 to 2013. Clinical data for NSCLC resections from The Society of Thoracic Surgery Database linked to Medicare claims, resource use and cost of preoperative staging, surgery, and subsequent care through 4 years were examined. Outcomes were stratified by pathologic stage and surgical approach for stage I lobectomy patients. In the first 90 days costs ranged from $12,430 for stage I to $26,350 for stage IV. Cumulative costs ranged from $131,032 for stage I to $205,368 for stage IV. For the stage I lobectomy cohort, patients who had minimally invasive procedures had lower 4-year costs than thoracotomy patients ($120,346 versus $136,250).
AHRQ-funded; R01 HS022279.
Citation: Cowper PA, Feng L, Kosinski AS .
Initial and longitudinal cost of surgical resection for lung cancer.
Ann Thorac Surg 2021 Jun;111(6):1827-33. doi: 10.1016/j.athoracsur.2020.07.048..
Keywords: Cancer: Lung Cancer, Cancer, Surgery, Healthcare Costs
Spalluto LB, Lewis JA, Stolldorf D
Organizational readiness for lung cancer screening: a cross-sectional evaluation at a Veterans Affairs medical center.
Lung cancer has the highest cancer-related mortality in the United States and among Veterans. Screening of high-risk individuals with low-dose CT (LDCT) can improve survival through detection of early-stage lung cancer. Organizational factors that aid or impede implementation of this evidence-based practice in diverse populations are not well described. In this study, the investigators evaluated organizational readiness for change and change valence (belief that change is beneficial and valuable) for implementation of LDCT screening.
AHRQ-funded; HS026395.
Citation: Spalluto LB, Lewis JA, Stolldorf D .
Organizational readiness for lung cancer screening: a cross-sectional evaluation at a Veterans Affairs medical center.
J Am Coll Radiol 2021 Jun;18(6):809-19. doi: 10.1016/j.jacr.2020.12.010..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Implementation, Organizational Change
Hochheimer CJ, Sabo RT, Tong ST
Practice, clinician, and patient factors associated with the adoption of lung cancer screening.
This study sought to assess lung cancer screening uptake in three health systems. Findings showed that certain patients appeared more likely to be screened. Of the three systems studied, the only one with increased lung cancer screening explicitly promoted screening rather than relying on clinicians to implement the new 2013 USPSTF guideline.
AHRQ-funded; HS025032.
Citation: Hochheimer CJ, Sabo RT, Tong ST .
Practice, clinician, and patient factors associated with the adoption of lung cancer screening.
J Med Screen 2021 Jun;28(2):158-62. doi: 10.1177/0969141320937326..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Guidelines
Panagiotou OA, Keeney T, Ogarek JA
Prevalence of functional limitations and their associations with systemic cancer therapy among older adults in nursing homes with advanced non-small cell lung cancer.
The purpose of this study was to determine the relationship of self-care task disabilities with the use of systemic cancer therapies for advanced non-small cell lung cancer (NSCLC) in nursing home patients. The investigators concluded that systemic cancer therapy was not commonly used in this population and was strongly predicted by disability in self-care tasks.
AHRQ-funded; HS000011.
Citation: Panagiotou OA, Keeney T, Ogarek JA .
Prevalence of functional limitations and their associations with systemic cancer therapy among older adults in nursing homes with advanced non-small cell lung cancer.
J Geriatr Oncol 2021 Jun;12(5):765-70. doi: 10.1016/j.jgo.2021.02.007..
Keywords: Elderly, Cancer: Lung Cancer, Cancer, Nursing Homes
Meza R, Jeon J, Toumazis I
Evaluation of the benefits and harms of lung cancer screening with low-dose computed tomography: modeling study for the US Preventive Services Task Force.
The purpose of this study was to inform the USPSTF guidelines by estimating the benefits and harms associated with various low-dose computed tomography (LDCT) screening strategies. Microsimulation modeling studies suggested that LDCT screening for lung cancer compared with no screening may increase lung cancer deaths averted and life-years gained when optimally targeted and implemented. Screening individuals at aged 50 or 55 years through aged 80 years with 20 pack-years or more of smoking exposure was estimated to result in more benefits than the 2013 USPSTF-recommended criteria and less disparity in screening eligibility by sex and race/ethnicity.
AHRQ-funded; 290201500011I.
Citation: Meza R, Jeon J, Toumazis I .
Evaluation of the benefits and harms of lung cancer screening with low-dose computed tomography: modeling study for the US Preventive Services Task Force.
JAMA 2021 Mar 9;325(10):988-97. doi: 10.1001/jama.2021.1077..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Lung Cancer, Cancer, Imaging, Screening, Prevention, Evidence-Based Practice, Guidelines
Jonas DE, Reuland DS, Reddy SM
Screening for lung cancer with low-dose computed tomography: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to review the evidence on screening for lung cancer with low-dose computed tomography (LDCT) to inform the USPSTF. Findings showed that screening high-risk persons with LDCT can reduce lung cancer mortality but can also cause false-positive results leading to unnecessary tests and invasive procedures, overdiagnosis, incidental findings, increases in distress, and, rarely, radiation-induced cancers.
AHRQ-funded; 290201500011I.
Citation: Jonas DE, Reuland DS, Reddy SM .
Screening for lung cancer with low-dose computed tomography: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Mar 9;325(10):971-87. doi: 10.1001/jama.2021.0377..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Lung Cancer, Cancer, Imaging, Screening, Prevention, Evidence-Based Practice
Feliciano JL, Waldfogel JM, Sharma R
Pharmacologic interventions for breathlessness in patients with advanced cancer: a systematic review and meta-analysis.
This systematic review and meta-analysis examined the use of pharmacological interventions for breathlessness in patients with advanced cancer. Studies were identified from database inception to May 2020 using predefined eligibility criteria. Pharmacologic intervention benefits and harms were compared, focusing on breathlessness, anxiety, exercise capacity and health-related quality of life. Out of 7729 unique citations, 19 studies with a total of 1424 patients were included. Opioids were not associated with more effectiveness than placebo for improving breathlessness or exercise capacity. Anxiolytics were also not associated with more effectiveness than placebo for breathlessness or anxiety. There was limited evidence for other pharmacologic interventions. There was some harm, but it was minimal in those short-term studies.
AHRQ-funded; 290201500006I.
Citation: Feliciano JL, Waldfogel JM, Sharma R .
Pharmacologic interventions for breathlessness in patients with advanced cancer: a systematic review and meta-analysis.
JAMA Netw Open 2021 Feb;4(2):e2037632. doi: 10.1001/jamanetworkopen.2020.37632..
Keywords: Cancer: Lung Cancer, Cancer, Respiratory Conditions, Medication, Treatments, Opioids, Evidence-Based Practice, Comparative Effectiveness, Quality of Life, Outcomes, Patient-Centered Outcomes Research
Rashdan S, Yang H, Le T
Prevalence and significance of potential pharmacokinetic drug-drug interactions among patients with lung cancer: implications for clinical trials.
The overall prevalence of potential drug-drug interactions (DDIs) among patients with lung cancer is unknown. The objective of this study was to determine the prevalence of potential DDIs and major DDIs among individuals newly diagnosed with lung cancer in a national cohort. The investigators concluded that medications with potential DDIs were prescribed to the majority of patients with lung cancer; however, only about 5% of patients were prescribed medications with major DDIs that might be prohibited in certain clinical trials.
AHRQ-funded; HS022418.
Citation: Rashdan S, Yang H, Le T .
Prevalence and significance of potential pharmacokinetic drug-drug interactions among patients with lung cancer: implications for clinical trials.
Clin Drug Investig 2021 Feb;41(2):161-67. doi: 10.1007/s40261-020-00994-4.
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Keywords: Cancer: Lung Cancer, Cancer, Adverse Drug Events (ADE), Adverse Events, Medication
Reese TJ, Schlechter CR, Potter LN
Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations.
The purpose of this study was to determine the changes associated with the revised USPSTF guideline for lung cancer screening eligibility among female, Black, and Hispanic populations using a large nationwide survey. The investigators concluded that the revised USPSTF guideline may likely increase lung cancer screening rates for female, Black, and Hispanic populations. However, despite these potential improvements, lung cancer screening inequities may persist without tailored eligibility criteria.
AHRQ-funded; HS026198.
Citation: Reese TJ, Schlechter CR, Potter LN .
Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations.
JAMA Netw Open 2021 Jan;4(1):e2033769. doi: 10.1001/jamanetworkopen.2020.33769..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Lung Cancer, Cancer, Screening, Racial and Ethnic Minorities, Women, Guidelines, Evidence-Based Practice
Gerber DE, Reimer T, Williams EL
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
This article describes the care processes for a 64-year-old man with newly diagnosed advanced non-small-cell lung cancer who was enrolled in a first-line clinical trial of a new immunotherapy regimen. Research team and clinical team members have limited knowledge of the roles and work of individuals outside their team. Recommendations to increase trust and collaboration are provided.
AHRQ-funded; HS022418.
Citation: Gerber DE, Reimer T, Williams EL .
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
J Oncol Pract 2016 Nov;12(11):1020-28. doi: 10.1200/jop.2016.013060.
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Keywords: Cancer, Cancer: Lung Cancer, Case Study, Healthcare Delivery, Patient-Centered Healthcare, Teams
Nadpara PA, Madhavan SS, Tworek C
Tobacco-use cessation counseling service usage.
The authors evaluated patterns of receipt of Tobacco-use Cessation Counseling (TCC) services among elderly lung cancer patients. They found a critical need to address disparities in receipt of TCC services among elderly. They concluded that, although lung cancer preventive services are covered under the Medicare program, these services are underutilized.
AHRQ-funded; HS018622.
Citation: Nadpara PA, Madhavan SS, Tworek C .
Tobacco-use cessation counseling service usage.
W V Med J 2016 Sep-Oct;112(5):66-71.
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Keywords: Cancer, Cancer: Lung Cancer, Elderly, Healthcare Utilization, Lifestyle Changes, Tobacco Use
Laccetti AL, Pruitt SL, Xuan L
Prior cancer does not adversely affect survival in locally advanced lung cancer: a national SEER-Medicare analysis.
Researchers identified patients > 65 years of age diagnosed 1992-2009 with locally advanced lung cancer in the Surveillance, Epidemiology, and End Results-Medicare linked dataset. They found that, for patients with locally advanced lung cancer, prior cancer does not adversely impact clinical outcomes. Patients with locally advanced lung cancer and a history of prior cancer should not be excluded from clinical trials.
AHRQ-funded; HS022418.
Citation: Laccetti AL, Pruitt SL, Xuan L .
Prior cancer does not adversely affect survival in locally advanced lung cancer: a national SEER-Medicare analysis.
Lung Cancer 2016 Aug;98:106-13. doi: 10.1016/j.lungcan.2016.05.029.
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Keywords: Elderly, Cancer: Lung Cancer, Medicare, Mortality, Patient-Centered Outcomes Research
Fernandez FG, Kosinski AS, Burfeind W
The Society of Thoracic Surgeons lung cancer resection risk model: higher quality data and superior outcomes.
The researchers updated the lung cancer resection risk model utilizing the Society of Thoracic Surgeons General Thoracic Surgery Database (GTSD) with a larger and more contemporary cohort. Risk factors from the prior lung cancer resection model were refined, and new risk factors such as prior thoracic surgery were identified. They concluded that operative mortality and complication rates were low for lung cancer resection among surgeons participating in the GTSD.
AHRQ-funded; HS022279.
Citation: Fernandez FG, Kosinski AS, Burfeind W .
The Society of Thoracic Surgeons lung cancer resection risk model: higher quality data and superior outcomes.
Ann Thorac Surg 2016 Aug;102(2):370-7. doi: 10.1016/j.athoracsur.2016.02.098.
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Keywords: Cancer: Lung Cancer, Risk, Surgery, Patient Safety
Healy MA, Yin H, Reddy RM
Use of positron emission tomography to detect recurrence and associations with survival in patients with lung and esophageal cancers.
The researchers sought to evaluate utilization of positron emission tomography (PET) to detect recurrence in asymptomatic patients and relationships with survival for patients with lung and esophageal cancers. Despite statistically significant variation in use of PET to detect tumor recurrence, there was no association with improved two-year survival.
AHRQ-funded; HS020937.
Citation: Healy MA, Yin H, Reddy RM .
Use of positron emission tomography to detect recurrence and associations with survival in patients with lung and esophageal cancers.
J Natl Cancer Inst 2016 Jul;108(7). doi: 10.1093/jnci/djv429.
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Keywords: Imaging, Cancer, Cancer: Lung Cancer, Healthcare Utilization
Fernandez FG, Furnary AP, Kosinski AS
Longitudinal follow-up of lung cancer resection from the Society of Thoracic Surgeons General Thoracic Surgery Database in patients 65 years and older.
The purpose of this paper was to provide longitudinal follow-up to the Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD) through linkage to the Centers for Medicare and Medicaid Services (CMS) data for patients 65 years of age or older. The researchers found that median survival after lung cancer resection was 6.7 years for pathologic stage I, 3.5 years for stage II, 2.4 years for stage III, and 2.2 years for stage IV. They concluded that CMS data complement the STS GTSD data by enabling examination of long-term survival and resource utilization in patients 65 years or older.
AHRQ-funded; HS022279.
Citation: Fernandez FG, Furnary AP, Kosinski AS .
Longitudinal follow-up of lung cancer resection from the Society of Thoracic Surgeons General Thoracic Surgery Database in patients 65 years and older.
Ann Thorac Surg 2016 Jun;101(6):2067-76. doi: 10.1016/j.athoracsur.2016.03.034.
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Keywords: Cancer: Lung Cancer, Surgery, Elderly, Outcomes, Mortality
Nadpara PA, Madhavan SS, Tworek C
Disparities in lung cancer care and outcomes among elderly in a medically underserved state population-a cancer registry-linked database study.
The purpose of this study was to evaluate the patterns of lung cancer care and associated health outcomes among elderly residing in a rural and medically underserved area. The authors found that delays in diagnosis and treatment varied significantly: survival outcomes significantly improved with appropriate care but did not improve with timely care. They concluded that their study highlights the critical need to address disparities in receipt of guideline-concordant lung cancer care among the elderly residing in rural and medically underserved areas.
AHRQ-funded; HS018622.
Citation: Nadpara PA, Madhavan SS, Tworek C .
Disparities in lung cancer care and outcomes among elderly in a medically underserved state population-a cancer registry-linked database study.
Popul Health Manag 2016 Apr;19(2):109-19. doi: 10.1089/pop.2015.0027.
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Keywords: Disparities, Elderly, Cancer: Lung Cancer, Outcomes, Vulnerable Populations
Lee SC, Marks EG, Sanders JM
Elucidating patient-perceived role in "decision-making" among African Americans receiving lung cancer care through a county safety-net system.
The researchers explored patient-perceived role in "decision-making" related to active treatment and palliation among African Americans receiving lung cancer care through a county safety-net system. They found that caregivers and patients expressed a concurrent lack of understanding of their prognosis and outcomes of treatment. Dyads did not discuss their lung cancer experience in terms of decision-making; rather, most articulated their role as following physician guidance.
AHRQ-funded; HS022418.
Citation: Lee SC, Marks EG, Sanders JM .
Elucidating patient-perceived role in "decision-making" among African Americans receiving lung cancer care through a county safety-net system.
J Cancer Surviv 2016 Feb;10(1):153-63. doi: 10.1007/s11764-015-0461-z.
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Keywords: Cancer: Lung Cancer, Cancer, Racial and Ethnic Minorities, Shared Decision Making, Clinician-Patient Communication
Rajaram R, Paruch JL, Mohanty S
Patterns and predictors of chemotherapy use for resected non-small cell lung cancer.
The researchers sought to evaluate chemotherapy use in resected stage IB to IIIA non-small cell lung cancer (NSCLC) over time and to identify predictors of perioperative chemotherapy administration. They found that the use of chemotherapy has significantly increased in patients with resected stage IB to IIIA NSCLC.
AHRQ-funded; HS000078.
Citation: Rajaram R, Paruch JL, Mohanty S .
Patterns and predictors of chemotherapy use for resected non-small cell lung cancer.
Ann Thorac Surg 2016 Feb;101(2):533-40. doi: 10.1016/j.athoracsur.2015.08.077..
Keywords: Treatments, Cancer: Lung Cancer, Surgery, Outcomes, Quality Improvement
Roth JA, Ramsey SD
Computed tomography screening for lung cancer: A high-value proposition?
This study assessed the cost-effectiveness of low-dose computed tomographic scan screening for lung cancer within the Canadian health care system. It found that compared with no screening, the reference scenario saved 51,000 quality-adjusted life-years (QALY) and had an incremental cost-effectiveness ratio of CaD $52,000/QALY.
HS022982.
Citation: Roth JA, Ramsey SD .
Computed tomography screening for lung cancer: A high-value proposition?
JAMA 2016 Jan 5;315(1):77-8. doi: 10.1001/jama.2015.17877..
Keywords: Cancer: Lung Cancer, Imaging, Screening, Healthcare Costs, Quality of Life