National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (1)
- Cancer (15)
- Cancer: Breast Cancer (2)
- Cancer: Colorectal Cancer (1)
- (-) Cancer: Lung Cancer (21)
- Case Study (1)
- Clinician-Patient Communication (1)
- Diagnostic Safety and Quality (2)
- Disabilities (1)
- Disparities (2)
- Elderly (4)
- Evidence-Based Practice (1)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Healthcare Utilization (2)
- Health Insurance (1)
- Health Services Research (HSR) (1)
- Health Status (1)
- Imaging (4)
- Lifestyle Changes (1)
- Medicaid (1)
- Medicare (1)
- Medication (1)
- Mortality (3)
- Opioids (1)
- Outcomes (4)
- Pain (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (1)
- Policy (2)
- Practice Patterns (1)
- Prevention (2)
- Quality Improvement (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (2)
- Respiratory Conditions (1)
- Risk (1)
- Rural/Inner-City Residents (1)
- Rural Health (1)
- Screening (4)
- Shared Decision Making (1)
- Surgery (6)
- Teams (1)
- Tobacco Use (1)
- Treatments (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Urban Health (1)
- Vulnerable Populations (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 21 of 21 Research Studies DisplayedOnaitis 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.
.
.
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.
.
.
Keywords: Cancer: Breast Cancer, Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer, Health Insurance, Medicaid, Policy, Health Services Research (HSR)
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.
.
.
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.
.
.
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.
.
.
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.
.
.
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.
.
.
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.
.
.
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.
.
.
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.
.
.
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
Smieliauskas F, MacMahon H, Salgia R
Geographic variation in radiologist capacity and widespread implementation of lung cancer CT screening.
The researchers estimated the prevalence of capacity constraints in the radiologist workforce and resulting potential disparities in access to lung cancer screening. They found that scaling up lung cancer screening would increase imaging procedures by an average of 4% across Health Service Areas (HSAs). HSAs that were rural, with many eligible smokers, and disproportionately Hispanic or low-income smokers had significantly higher odds of facing capacity constraints.
AHRQ-funded; HS018535.
Citation: Smieliauskas F, MacMahon H, Salgia R .
Geographic variation in radiologist capacity and widespread implementation of lung cancer CT screening.
J Med Screen 2014 Dec;21(4):207-15. doi: 10.1177/0969141314548055..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer, Cancer: Lung Cancer, Screening, Imaging
Gerber DE, Laccetti AL, Xuan L
Impact of prior cancer on eligibility for lung cancer clinical trials.
A prior cancer diagnosis often excludes patients from cancer clinical trials. Lung cancer patients were used to determine estimated impact on trial accrual. This study found that patients previously diagnosed with cancer were excluded in more than two-thirds of lung cancer trials. More research is needed to understand the basis of this policy.
AHRQ-funded; HS022418
Citation: Gerber DE, Laccetti AL, Xuan L .
Impact of prior cancer on eligibility for lung cancer clinical trials.
J Natl Cancer Inst. 2014 Nov;106(11). doi: 10.1093/jnci/dju302..
Keywords: Cancer: Lung Cancer, Policy, Cancer, Diagnostic Safety and Quality
Deppen SA, Blume JD, Kensinger CD
Accuracy of FDG-PET to diagnose lung cancer in areas with infectious lung disease: a meta-analysis.
The purpose of this study was to estimate the diagnostic accuracy of positron emission tomography (PET) combined with fludeoxyglucose F18 (FDG) for pulmonary modules suspicious for lung cancer in regions where infectious lung disease is endemic and compare the accuracy in regions where such disease is rare. It found that the accuracy of FDG-PET was extremely heterogeneous.
AHRQ-funded; HS021554.
Citation: Deppen SA, Blume JD, Kensinger CD .
Accuracy of FDG-PET to diagnose lung cancer in areas with infectious lung disease: a meta-analysis.
JAMA 2014 Sep 24;312(12):1227-36. doi: 10.1001/jama.2014.11488..
Keywords: Cancer, Cancer: Lung Cancer, Diagnostic Safety and Quality, Respiratory Conditions, Imaging
Davidoff AJ, Gardner LD, Zuckerman IH
AHRQ Author: Davidoff AJ
Validation of disability status, a claims-based measure of functional status for cancer treatment and outcomes studies.
The researchers implemented and validated a disability status (DS) measure in 4 cohorts of cancer patients. They found that the DS measure is a significant independent predictor of cancer-directed treatment, but unobserved factors continue to play a role in determining treatments.
AHRQ-authored.
Citation: Davidoff AJ, Gardner LD, Zuckerman IH .
Validation of disability status, a claims-based measure of functional status for cancer treatment and outcomes studies.
Med Care 2014 Jun;52(6):500-10. doi: 10.1097/mlr.0000000000000122.
.
.
Keywords: Cancer, Cancer: Breast Cancer, Disabilities, Health Status, Cancer: Lung Cancer