National Healthcare Quality and Disparities Report
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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 11 of 11 Research Studies DisplayedHerb J, Friedman H, Shrestha S
Prevalence and risk factors associated with readmission with acute kidney injury in patients receiving vancomycin outpatient parenteral antimicrobial therapy.
The purpose of this study was to understand barriers to early-stage lung cancer care at high-volume academic centers in the US. Researchers conducted semi-structured interviews with patients with suspected or diagnosed early-stage non-small cell lung cancer who had presented to a multidisciplinary clinic at academic institutions over a 6-month period; a qualitative content analysis was then performed using the framework method. Six themes relating to barriers and facilitators to lung-cancer care were identified, and the authors concluded that these factors must be addressed to improve quality of care among lung cancer patients.
AHRQ-funded; HS000032.
Citation: Herb J, Friedman H, Shrestha S .
Prevalence and risk factors associated with readmission with acute kidney injury in patients receiving vancomycin outpatient parenteral antimicrobial therapy.
Support Care Cancer 2022 Dec 14;31(1):21. doi: 10.1007/s00520-022-07465-w..
Keywords: Cancer: Lung Cancer, Cancer, Access to Care
Liu MA, Keeney T, Papaila A
Functional status and survival in older nursing home residents with advanced non-small-cell lung cancer: a SEER-Medicare analysis.
The purpose of this study was to examine the association between activities of daily living (ADL) impairment and overall survival in patients 65 and older with advanced non-small-cell lung cancer (NSCLC) receiving care in nursing homes from 2011 to 2015. The researchers examined the association between ADL scores and overall survival among 3,174 patients who received systemic cancer chemotherapy or immunotherapy within 3 months of NSCLC diagnosis; and among patients who did not receive any treatment. The study found that the ADL score was associated with increased risk of death. One standard deviation increase in the ADL score was associated with lower overall survival rate among treated and untreated patients The median overall survival was 3.1 months for patients with an ADL score of less than 14, 2.8 months for patients with an ADL score between 14 and 17, 2.3 months for patients with ADL score between 18-19, and 1.8 months for patients with ADL score of 20+. The researchers concluded that the ADL assessment may be a useful clinical tool in nursing home adults aged 65 and older with advanced non-small-cell lung cancer.
AHRQ-funded; HS000011.
Citation: Liu MA, Keeney T, Papaila A .
Functional status and survival in older nursing home residents with advanced non-small-cell lung cancer: a SEER-Medicare analysis.
JCO Oncol Pract 2022 Jun;18(6):e886-e95. doi: 10.1200/op.21.00460..
Keywords: Elderly, Nursing Homes, Cancer: Lung Cancer, Cancer
Kukhareva PV, Caverly TJ, Li H
Inaccuracies in electronic health records smoking data and a potential approach to address resulting underestimation in determining lung cancer screening eligibility.
The authors sought to characterize EHR smoking data issues and to propose an approach to addressing these issues using longitudinal smoking data. They found that over 80% of evaluated records had inaccuracies, including missing packs-per-day or years-smoked, outdated data, missing years-quit, and a recent change in packs-per-day resulting in inaccurate lifetime pack-years estimation. Further, addressing these issues by using longitudinal data enabled the identification of 49.4% more patients potentially eligible for lung cancer screening.
AHRQ-funded; HS026198.
Citation: Kukhareva PV, Caverly TJ, Li H .
Inaccuracies in electronic health records smoking data and a potential approach to address resulting underestimation in determining lung cancer screening eligibility.
J Am Med Inform Assoc 2022 Apr 13;29(5):779-88. doi: 10.1093/jamia/ocac020..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Screening, Cancer: Lung Cancer, Cancer
Reese TJ, Schlechter CR, Kramer H
Implementing lung cancer screening in primary care: needs assessment and implementation strategy design.
This study explored the implementation of lung cancer screening with low-dose computed tomography (CT) in primary care. The study’s two goals included exploring the implementation of lung cancer screening primary care in the context of integrating a decision aid into the electronic health record and a designing of implementation strategies that target hypothesized mechanics of change and context-specific barriers. The two phases included a Qualitative Analysis phase including semi-structured interviews with primary care physicians to elicit key task behaviors, and an Implementation Strategy Design phase consisting of defining implementation strategies and hypothesizing causal pathways to improve screening with a decision aid. Fourteen interviews were conducted and out of that 3 key task behaviors and four behavioral determinants emerged. Strategies included increasing provider self-efficacy toward performing shared decision making and using the decision aid, improving provider performance expectancy, increasing social influence, and addressing key facilitators to using the decision aid.
AHRQ-funded; HS026198.
Citation: Reese TJ, Schlechter CR, Kramer H .
Implementing lung cancer screening in primary care: needs assessment and implementation strategy design.
Transl Behav Med 2022 Feb 16;12(2):187-97. doi: 10.1093/tbm/ibab115..
Keywords: Cancer: Lung Cancer, Cancer, Primary Care, Screening, Implementation, Shared Decision Making
Onaitis MW, Furnary AP, Kosinski AS
Equivalent survival between lobectomy and segmentectomy for clinical stage IA lung cancer.
This study compared the effectiveness of lobectomy and segmentectomy for treatment of clinical stage IA (T1N0) lung cancer patients. The Society of Thoracic Surgeons General Thoracic Surgery Database was linked to Medicare data in 14,286 lung cancer patients who underwent segmentectomy (n = 1654) or lobectomy (n = 12,632) from 2002 to 2015. Survival rates were found to be similar.
AHRQ-funded; HS022279.
Citation: Onaitis MW, Furnary AP, Kosinski AS .
Equivalent survival between lobectomy and segmentectomy for clinical stage IA lung cancer.
Ann Thorac Surg 2020 Dec;110(6):1882-91. doi: 10.1016/j.athoracsur.2020.01.020..
Keywords: Cancer: Lung Cancer, Cancer, Surgery, Mortality, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Brown TJ Keshvani, N Gupta, et al.
Rates of appropriate laxative prophylaxis for opioid-induced constipation in veterans with lung cancer: a retrospective cohort study.
This study examined trends in the use of laxatives for opioid-induced constipation (OIC) in patients prescribed opioids for cancer pain treatment. A retrospective study was conducted of lung cancer patients seen in the Veteran’s Affair system from 2003 to 2016. There were 130,990 individuals included in the analysis. The majority (87%) received no prophylaxis (75%) or received docusate alone while 5% received OIC prophylaxis with the unnecessary addition of docusate. Throughout the study period, laxative prescription significantly decreased while categories of OIC prophylaxis were unchanged. The study concluded that almost 90% received inadequate or inappropriate OIC prophylaxis.
AHRQ-funded; HS022418.
Citation: Brown TJ Keshvani, N Gupta, et al..
Rates of appropriate laxative prophylaxis for opioid-induced constipation in veterans with lung cancer: a retrospective cohort study.
Support Care Cancer 2020 Nov;28(11):5315-21. doi: 10.1007/s00520-020-05364-6..
Keywords: Cancer: Lung Cancer, Cancer, Opioids, Medication, Prevention, Pain
Herb JN, Dunham LN, Mody G
Lung cancer surgical regionalization disproportionately worsens travel distance for rural patients.
Researchers hypothesized that lung cancer patients have been traveling further for surgery over time as regionalization has occurred, and this increased travel has primarily impacted rural patients. Using data from a North Carolina all-payer state discharge database, they found that the number of hospitals performing lung cancer resections decreased from 49 to 31 over the study period, and the proportion of patients receiving care at high-volume centers increased. Rural patient travel distance increased over time by 8.5 miles, with no change in urban patient travel distance. They concluded that, in North Carolina, lung cancer surgical regionalization occurred over the study period and was accompanied by increases in travel distance for rural patients only. They recommended further work to determine the effects of greater travel distance on patterns of cancer care for rural patients.
AHRQ-funded; HS000032.
Citation: Herb JN, Dunham LN, Mody G .
Lung cancer surgical regionalization disproportionately worsens travel distance for rural patients.
J Rural Health 2020 Sep;36(4):496-505. doi: 10.1111/jrh.12440..
Keywords: Cancer: Lung Cancer, Cancer, Rural Health, Surgery, Access to Care
Gerber DE, Hamann HA, Chavez C
Tracking the nonenrolled: lung cancer screening patterns among individuals not accrued to a clinical trial.
Researchers investigated lung cancer screening patterns among individuals eligible for, but not enrolled in, a screening trial. They found that, in their single-center study, demographic factors did not predict for participation in a lung cancer screening trial; lung cancer screening adherence rates were substantially lower for those not enrolled in a screening trial, especially for those who could not be contacted. The researchers conclude that these findings may inform the broader implementation of screening programs.
AHRQ-funded; HS022418.
Citation: Gerber DE, Hamann HA, Chavez C .
Tracking the nonenrolled: lung cancer screening patterns among individuals not accrued to a clinical trial.
Clin Lung Cancer 2020 Jul;21(4):326-32. doi: 10.1016/j.cllc.2020.02.010..
Keywords: Cancer: Lung Cancer, Cancer, Screening
Ezer N, Mhango G, Bagiella E
Racial disparities in resection of early stage non-small cell lung cancer: variability among surgeons.
This study examined racial disparities in resection surgery of non-small cell lung cancer (NSCLC). These disparities are well documented. The authors identified 19,624 patients with stage I-II NSCLC 65 years and older from the SEER-Medicare database. They studied patients evaluated by a surgeon within 6 months of diagnosis. Black patients were less likely to undergo resection with resection rates varying among surgeons. Thoracic surgeon specialists were less likely to have any disparities with resection rates.
AHRQ-funded; HS019670.
Citation: Ezer N, Mhango G, Bagiella E .
Racial disparities in resection of early stage non-small cell lung cancer: variability among surgeons.
Med Care 2020 Apr;58(4):392-98. doi: 10.1097/mlr.0000000000001280..
Keywords: Disparities, Racial and Ethnic Minorities, Cancer: Lung Cancer, Cancer, Surgery, Practice Patterns
Lee SJC, Hamann HA, Browning T
Stakeholder engagement to initiate lung cancer screening in an urban safety-net health system.
The authors sought to develop a population-based lung cancer screening program using low-dose computed tomography imaging at Parkland Health & Hospital System, Dallas County, Texas, providing coverage of uninsured patients through a combination of Medicare, Medicaid, and the Dallas medical assistance program for under- and uninsured, low-income county residents. They found that establishing a uniform clinical pathway connecting different clinical specialists requires a system-level view of care coordination to ensure that referrals trigger appointments, result reporting, and follow-up. Additionally, primary care providers need to educate and refer patients, address smoking cessation needs, and document shared decision-making counseling between the referring provider and the patient.
AHRQ-funded; HS022418.
Citation: Lee SJC, Hamann HA, Browning T .
Stakeholder engagement to initiate lung cancer screening in an urban safety-net health system.
Healthc 2020 Mar;8(1):100370. doi: 10.1016/j.hjdsi.2019.100370.
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Keywords: Cancer: Lung Cancer, Cancer, Screening, Prevention, Urban Health, Rural/Inner-City Residents
Takvorian SU, Oganisian A, Mamtani R
Association of Medicaid expansion under the Affordable Care Act with insurance status, cancer stage, and timely treatment among patients with breast, colon, and lung cancer.
The effect of the Patient Protection and Affordable Care Act's Medicaid expansion on cancer care delivery and outcomes is unknown. Patients with cancer are a high-risk group for whom treatment delays are particularly detrimental. The objective of this study was to examine the association between Medicaid expansion and changes in insurance status, stage at diagnosis, and timely treatment among patients with incident breast, colon, and non-small cell lung cancer.
AHRQ-funded; HS026116.
Citation: Takvorian SU, Oganisian A, Mamtani R .
Association of Medicaid expansion under the Affordable Care Act with insurance status, cancer stage, and timely treatment among patients with breast, colon, and lung cancer.
JAMA Netw Open 2020 Feb 5;3(2):e1921653. doi: 10.1001/jamanetworkopen.2019.21653.
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Keywords: Cancer: Breast Cancer, Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer, Health Insurance, Medicaid, Policy, Health Services Research (HSR)