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
51 to 75 of 83 Research Studies DisplayedMeyer AND, Singh H
Calibrating how doctors think and seek information to minimise errors in diagnosis.
This editorial discusses a study by Sheringham et al., published in 2017 in BMJ Quality and Safety, and entitled “Variations in GPs’ decisions to investigate suspected lung cancer: a factorial experiment using multimedia vignettes” in which they used simulated patient vignettes to understand the role that patient characteristics (including demographics and symptomatology) play in physicians’ decisions to investigate for possible diagnosis of lung cancer.
AHRQ-funded; HS022087; HS023602.
Citation: Meyer AND, Singh H .
Calibrating how doctors think and seek information to minimise errors in diagnosis.
BMJ Qual Saf 2017 Jun;26(6):436-38. doi: 10.1136/bmjqs-2016-006071..
Keywords: Cancer: Lung Cancer, Shared Decision Making, Diagnostic Safety and Quality
Iyer AS, Bakitas M
Early palliative care in advanced illness: do right by mama.
This letter describes a case study where the doctor and the family decided not to do aggressive treatment on their mother in her 80’s with metastatic lung cancer and pneumonia. After describing the intubation procedure and the use of mechanical ventilation, the family decided that palliative care was the best option. The doctor emphasizes the use of palliative care as the best outcome for many terminally ill patients.
AHRQ-funded; HS023009; HS013852.
Citation: Iyer AS, Bakitas M .
Early palliative care in advanced illness: do right by mama.
JAMA Intern Med 2017 Jun;177(6):761-62. doi: 10.1001/jamainternmed.2017.0764.
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Keywords: Cancer, Cancer: Lung Cancer, Case Study, Shared Decision Making, Elderly, Palliative Care, Patient-Centered Outcomes Research
Kao CJ, Wurz GT, Lin YC
Repurposing ospemifene for potentiating an antigen-specific immune response.
The overall objective of the present series of preclinical studies was to evaluate the immunomodulatory activity of ospemifene in combination with a peptide cancer vaccine. The authors concluded that, taken together, ospemifene's dose response and schedule-dependent immune modulating activity offers a method of tailoring and augmenting the efficacy of previously failed antigen-specific cancer vaccines for a wide range of malignancies.
AHRQ-funded; HS022236.
Citation: Kao CJ, Wurz GT, Lin YC .
Repurposing ospemifene for potentiating an antigen-specific immune response.
Menopause 2017 Apr;24(4):437-51. doi: 10.1097/gme.0000000000000776.
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Keywords: Cancer: Breast Cancer, Cancer: Lung Cancer, Medication, Vaccination
Pruitt SL, Laccetti AL, Xuan L
Revisiting a longstanding clinical trial exclusion criterion: impact of prior cancer in early-stage lung cancer.
The researchers examined the prevalence and prognostic impact of a prior cancer diagnosis among patients with early-stage lung cancer. They found no difference in all-cause survival between patients with and without prior cancer. Lung cancer specific survival was improved among patients with prior cancer.
AHRQ-funded; HS022418.
Citation: Pruitt SL, Laccetti AL, Xuan L .
Revisiting a longstanding clinical trial exclusion criterion: impact of prior cancer in early-stage lung cancer.
Br J Cancer 2017 Mar 14;116(6):717-25. doi: 10.1038/bjc.2017.27.
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Keywords: Research Methodologies, Cancer: Lung Cancer, Elderly, Patient-Centered Outcomes Research, Mortality
Roth JA, Goulart BH, Ravelo A
Survival gains from first-line systemic therapy in metastatic non-small cell lung cancer in the U.S., 1990-2015: progress and opportunities.
The objectives of this study were to quantify survival gains from 1990, when best supportive care only was standard, to 2015 and to estimate the impact of expanded use of new systemic therapies in clinically appropriate patients. By using simulation modeling to quantify metastatic non-small cell lung cancer survival gains from 1990-2015, the researchers estimated that the one-year survival proportion and mean per-patient survival increased by 14.1 percent and 4.2 months, respectively.
AHRQ-funded; HS022982.
Citation: Roth JA, Goulart BH, Ravelo A .
Survival gains from first-line systemic therapy in metastatic non-small cell lung cancer in the U.S., 1990-2015: progress and opportunities.
Oncologist 2017 Mar;22(3):304-10. doi: 10.1634/theoncologist.2016-0253.
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Keywords: Treatments, Health Status, Cancer: Lung Cancer, Mortality, Patient-Centered Outcomes Research
Liu S, Mazur TR, Li H
A method to reconstruct and apply 3D primary fluence for treatment delivery verification.
In this study, a method is reported to perform IMRT and VMAT treatment delivery verification using 3D volumetric primary beam fluences reconstructed directly from planned beam parameters and treatment delivery records. The goals of this paper are to demonstrate that 1) 3D beam fluences can be reconstructed efficiently, and 2) quality assurance (QA) based on the reconstructed 3D fluences is capable of detecting additional treatment delivery errors, particularly for VMAT plans.
AHRQ-funded; HS022888.
Citation: Liu S, Mazur TR, Li H .
A method to reconstruct and apply 3D primary fluence for treatment delivery verification.
J Appl Clin Med Phys 2017 Jan;18(1):128-38. doi: 10.1002/acm2.12017.
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Keywords: Patient Safety, Imaging, Cancer: Lung Cancer, Treatments, Quality of Care
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
Nadpara P, Madhavan SS, Tworek C
Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: a population-based study.
This study evaluated the variations in guideline-concordant timely lung cancer care and prognosis among elderly in the US. It found that the time to diagnosis and treatment varied significantly among the elderly. However, 77.5 percent received guideline-concordant timely lung cancer care. The likelihood of receiving timely care significantly decreased with early stage diagnosis, increasing age, non-white race, higher comorbidity score, and lower income.
AHRQ-funded; HS018622.
Citation: Nadpara P, Madhavan SS, Tworek C .
Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: a population-based study.
Cancer Epidemiol 2015 Dec;39(6):1136-44. doi: 10.1016/j.canep.2015.06.005.
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Keywords: Cancer: Lung Cancer, Elderly, Guidelines, Disparities, Diagnostic Safety and Quality
Du XL, Parikh RC, Lairson DR
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
The authors examined racial/ethnic and geographical disparities in cancer care and costs during the last 6 months of life for lung cancer decedents after the FDA's approval of bevacizumab. They found that there were substantial racial/ethnic and geographic disparities in the types of cancer care and costs in the last 6 months of life among lung cancer decedents, regardless of the length of survival times and hospice care status.
AHRQ-funded; HS018956.
Citation: Du XL, Parikh RC, Lairson DR .
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
Lung Cancer 2015 Dec;90(3):442-50. doi: 10.1016/j.lungcan.2015.09.017.
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Keywords: Cancer, Cancer: Lung Cancer, Disparities, Healthcare Costs, Medication, Palliative Care, Patient-Centered Outcomes Research, Practice Patterns, Racial and Ethnic Minorities
Murphy DR, Wu L, Thomas EJ
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
The researchers tested whether prospective use of electronic health record-based trigger algorithms to identify patients at risk of diagnostic delays could prevent delays in diagnostic evaluation for cancer. They found that electronic trigger-based interventions seem to be effective in reducing time to diagnostic evaluation of colorectal and prostate cancer as well as improving the proportion of patients who receive follow-up.
AHRQ-funded; HS017820.
Citation: Murphy DR, Wu L, Thomas EJ .
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
J Clin Oncol 2015 Nov 1;33(31):3560-7. doi: 10.1200/jco.2015.61.1301..
Keywords: Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer: Prostate Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Grenda TR, Revels SL, Yin H
Lung cancer resection at hospitals with high vs low mortality rates.
The objective of this study was to evaluate perioperative outcomes in patients who underwent lung cancer resection at high-mortality hospitals [HMHs] and low-mortality hospitals [LMHs]) in order to better understand the factors related to differences in mortality rates after lung cancer resection. It concluded that failure-to-rescue rates are higher at HMHs, which may explain the large differences between hospitals in mortality rates following lung cancer resection.
AHRQ-funded; HS000053; HS020937.
Citation: Grenda TR, Revels SL, Yin H .
Lung cancer resection at hospitals with high vs low mortality rates.
JAMA Surg 2015 Nov;150(11):1034-40. doi: 10.1001/jamasurg.2015.2199..
Keywords: Cancer: Lung Cancer, Surgery, Mortality, Outcomes, Patient Safety
Veluswamy RR, Ezer N, Mhango G
Limited resection versus lobectomy for older patients with early-stage lung cancer: Impact of histology.
The researchers used population-based data to assess the equivalency of limited resection versus lobectomy among older patients with stage IA invasive adenocarcinoma and squamous cell carcinoma less than 2 cm in size. They found generally that limited resection is not equivalent to lobectomy in older patients with invasive non–small-cell lung cancer, although segmentectomy may be equivalent in patients with adenocarcinoma.
AHRQ-funded; HS019670.
Citation: Veluswamy RR, Ezer N, Mhango G .
Limited resection versus lobectomy for older patients with early-stage lung cancer: Impact of histology.
J Clin Oncol 2015 Oct 20;33(30):3447-53. doi: 10.1200/jco.2014.60.6624..
Keywords: Cancer, Cancer: Lung Cancer, Comparative Effectiveness, Surgery
Murphy DR, Thomas EJ, Meyer AN
Development and validation of electronic health record-based triggers to detect delays in follow-up of abnormal lung imaging findings.
In this study, the researchers developed an electronic health record (EHR)-based trigger algorithm to identify delays in follow-up evaluation of patients with imaging findings suggestive of lung cancer. After validating the trigger with retrospective data, they concluded that EHR-based triggers can be used to identify patients with suspicious imaging findings in whom follow-up diagnostic evaluation was delayed.
AHRQ-funded; HS017820.
Citation: Murphy DR, Thomas EJ, Meyer AN .
Development and validation of electronic health record-based triggers to detect delays in follow-up of abnormal lung imaging findings.
Radiology 2015 Oct;277(1):81-7. doi: 10.1148/radiol.2015142530..
Keywords: Cancer: Lung Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Imaging
Wysham NG, Cox CE, Wolf SP
Symptom burden of chronic lung disease compared with lung cancer at time of referral for palliative care consultation.
The authors compared the symptom burden of chronic lung disease with that of lung cancer at the time of initial palliative care consultation. They found that patients with chronic lung disease have symptom burdens similar to those of patients with lung cancer at the time of the first palliative care encounter. They concluded that, given the population burden of chronic lung disease and limitations in the palliative care workforce, attention should be focused on ensuring that pulmonologists are prepared to assess and manage the common palliative care needs of patients with chronic lung disease.
AHRQ-funded; HS023681.
Citation: Wysham NG, Cox CE, Wolf SP .
Symptom burden of chronic lung disease compared with lung cancer at time of referral for palliative care consultation.
Ann Am Thorac Soc 2015 Sep;12(9):1294-301. doi: 10.1513/AnnalsATS.201503-180OC.
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Keywords: Respiratory Conditions, Cancer: Lung Cancer, Pain, Palliative Care, Patient-Centered Outcomes Research
Kenzik KM, Ganz PA, Martin MY
How much do cancer-related symptoms contribute to health-related quality of life in lung and colorectal cancer patients? A report from the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium.
The objective of this study was to examine associations of symptoms with physical and mental health-related quality of life (HRQOL) in patients with colorectal cancer (CRC) and in patients with lung cancer. It found that physical component summary scores for patients with CRC and lung cancer were below the general population norm of 50 (43 and 37, respectively), and mental component summary scores were at the population norm.
AHRQ-funded; HS013852.
Citation: Kenzik KM, Ganz PA, Martin MY .
How much do cancer-related symptoms contribute to health-related quality of life in lung and colorectal cancer patients? A report from the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium.
Cancer 2015 Aug 15;121(16):2831-9. doi: 10.1002/cncr.29415..
Keywords: Quality of Life, Cancer, Cancer: Lung Cancer, Outcomes
Roth JA, Sullivan SD, Goulart BH
Projected clinical, resource use, and fiscal impacts of implementing low-dose computed tomography lung cancer screening in Medicare.
The Centers for Medicare and Medicaid Services (CMS) recently issued a national coverage determination that provides reimbursement for low-dose computed tomography (CT) lung cancer screening for enrollees age 55 to 77 years. This study’s simulation model projected that over 5 years, that low-dose CT screening will result in 10.7 million more low-dose CT scans, 52,000 more lung cancers detected, and increased overall expenditure of $6.8 billion.
AHRQ-funded; HS022982.
Citation: Roth JA, Sullivan SD, Goulart BH .
Projected clinical, resource use, and fiscal impacts of implementing low-dose computed tomography lung cancer screening in Medicare.
J Oncol Pract 2015 Jul;11(4):267-72. doi: 10.1200/jop.2014.002600.
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Keywords: Cancer: Lung Cancer, Screening, Medicare, Healthcare Costs, Healthcare Utilization