National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Cancer (7)
- Cancer: Breast Cancer (1)
- Cancer: Colorectal Cancer (1)
- (-) Cancer: Lung Cancer (24)
- Care Management (1)
- Case Study (2)
- Clinician-Patient Communication (1)
- Comparative Effectiveness (2)
- Decision Making (4)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Elderly (9)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Healthcare Utilization (3)
- Health Information Technology (HIT) (1)
- Health Status (1)
- Hospital Discharge (1)
- Imaging (3)
- Lifestyle Changes (1)
- Medicare (2)
- Medication (1)
- Mortality (4)
- Outcomes (4)
- Palliative Care (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (6)
- Patient Experience (1)
- Patient Safety (2)
- Quality Improvement (1)
- Quality of Care (2)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Registries (1)
- Research Methodologies (1)
- Risk (1)
- Screening (2)
- Surgery (6)
- Teams (1)
- Tobacco Use (1)
- Transitions of Care (1)
- Treatments (4)
- Vaccination (1)
- Vulnerable Populations (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 24 of 24 Research Studies DisplayedBoffa DJ, Kosinski AS, Furnary AP
Minimally invasive lung cancer surgery performed by thoracic surgeons as effective as thoracotomy.
The study authors hypothesized that the minimally invasive video-assisted thoracic surgery (VATS) approach to lobectomy for stage I lung cancer resulted in a longitudinal outcome that was not inferior to thoracotomy. After conducting their study, they concluded that the long-term efficacy of lobectomy for stage I lung cancer performed using the VATS approach by board-certified thoracic surgeons does not seem to be inferior to that of thoracotomy.
AHRQ-funded; HS022279.
Citation: Boffa DJ, Kosinski AS, Furnary AP .
Minimally invasive lung cancer surgery performed by thoracic surgeons as effective as thoracotomy.
J Clin Oncol 2018 Aug 10;36(23):2378-85. doi: 10.1200/jco.2018.77.8977..
Keywords: Cancer: Lung Cancer, Comparative Effectiveness, Patient-Centered Outcomes Research, Surgery
Roth JA, Carter-Harris L, Brandzel S
A qualitative study exploring patient motivations for screening for lung cancer.
The purpose of this qualitative study was to explore the motivations for screening-eligible patients to screen for lung cancer. The investigators concluded that participants in their study were primarily motivated to screen for lung cancer based on perceived benefit of early-detection, absence of safety concerns, and personal relationships. They suggest that their findings can potentially be used to improve lung cancer screening uptake and shared decision-making processes.
AHRQ-funded; HS022982.
Citation: Roth JA, Carter-Harris L, Brandzel S .
A qualitative study exploring patient motivations for screening for lung cancer.
PLoS One 2018 Jul 5;13(7):e0196758. doi: 10.1371/journal.pone.0196758..
Keywords: Cancer: Lung Cancer, Decision Making, Healthcare Utilization, Screening
Roydhouse JK, Gutman R, Keating NL
Differences between proxy and patient assessments of cancer care experiences and quality ratings.
This study assessed the impact of proxy survey responses on cancer care experience reports and quality ratings. Adjusted proxy scores were modestly higher for medical care experiences but lower for nursing care and care coordination experiences. There were no significant differences between adjusted patient and proxy ratings of quality.
AHRQ-funded; HS000011.
Citation: Roydhouse JK, Gutman R, Keating NL .
Differences between proxy and patient assessments of cancer care experiences and quality ratings.
Health Serv Res 2018 Apr;53(2):919-43. doi: 10.1111/1475-6773.12672.
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Keywords: Cancer, Cancer: Colorectal Cancer, Cancer: Lung Cancer, Quality of Care, Patient Experience
Lacson R, Desai S, Landman A
Impact of a health information technology intervention on the follow-up management of pulmonary nodules.
Recommendations to improve care for patients with pulmonary nodules require follow-up management. However, transitions in care can exacerbate failures in follow-up testing and compromise patient safety. The study authors evaluated the impact of a discharge module that included follow-up recommendations for further management of pulmonary nodules on the study outcome and follow-up management of patients with pulmonary nodules within 1 year after discharge.
AHRQ-funded; HS022586.
Citation: Lacson R, Desai S, Landman A .
Impact of a health information technology intervention on the follow-up management of pulmonary nodules.
J Digit Imaging 2018 Feb;31(1):19-25. doi: 10.1007/s10278-017-9989-y..
Keywords: Cancer: Lung Cancer, Health Information Technology (HIT), Hospital Discharge, Transitions of Care
Khan SA, Pruitt SL, Xuan L
How does autoimmune disease impact treatment and outcomes among patients with lung cancer? A national SEER-Medicare analysis.
The advent of cancer immunotherapy has made autoimmune disease in oncology populations clinically important. The researchers analyzed the association of autoimmune disease with treatment and outcomes among lung cancer patients. They found that lung cancer treatment patterns were similar among patients with and without autoimmune disease and there was no significant association with mortality.
AHRQ-funded; HS022418.
Citation: Khan SA, Pruitt SL, Xuan L .
How does autoimmune disease impact treatment and outcomes among patients with lung cancer? A national SEER-Medicare analysis.
Lung Cancer 2018 Jan;115:97-102. doi: 10.1016/j.lungcan.2017.11.024.
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Keywords: Cancer: Lung Cancer, Patient-Centered Outcomes Research, Treatments
Ezer N, Kale M, Sigel K
Outcomes after video-assisted thoracoscopic lobectomy versus open lobectomy for early-stage lung cancer in older adults.
This study evaluated whether the improved perioperative outcomes associated with video-assisted thoracoscopic surgery (VATS) lobectomy are explained by surgeon characteristics, including case volume and specialty training. It concluded that VATS lobectomy for non-small cell lung cancer (NSCLC) is associated with better postoperative outcomes, but similar long-term survival, compared with open lobectomy among older adults, even after controlling for surgeon experience.
AHRQ-funded; HS019670.
Citation: Ezer N, Kale M, Sigel K .
Outcomes after video-assisted thoracoscopic lobectomy versus open lobectomy for early-stage lung cancer in older adults.
Ann Am Thorac Soc 2018 Jan;15(1):76-82. doi: 10.1513/AnnalsATS.201612-980OC.
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Keywords: Comparative Effectiveness, Elderly, Cancer: Lung Cancer, Surgery
Boffa D, Fernandez FG, Kim S
Surgically managed clinical stage iiia-clinical n2 lung cancer in the Society of Thoracic Surgeons Database.
The objective of this study was to characterize the management of clinical stage IIIA-N2 positive (cIIIA-N2) lung cancer in The Society of Thoracic Surgeons General Thoracic Surgery Database. Surgeons achieved excellent short- and long-term results treating predominantly lobectomy-amenable cIIIA-N2 lung cancer. However, prevalent overstaging and abstention from induction therapy suggested "overcoding" of false positives on imaging or variable compliance with current guidelines for cIIIA-N2 lung cancer.
AHRQ-funded; HS022279.
Citation: Boffa D, Fernandez FG, Kim S .
Surgically managed clinical stage iiia-clinical n2 lung cancer in the Society of Thoracic Surgeons Database.
Ann Thorac Surg 2017 Aug;104(2):395-403. doi: 10.1016/j.athoracsur.2017.02.031.
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Keywords: Surgery, Cancer: Lung Cancer, Registries, Elderly, Outcomes
Schuler MS, Joyce NR, Huskamp HA
Medicare beneficiaries with advanced lung cancer experience diverse patterns of care from diagnosis to death.
Using Medicare claims data for patients diagnosed with extensive-stage small-cell lung cancer, the authors used latent class analysis to identify classes of people with different care patterns. The findings showed substantial heterogeneity in patterns of care for patients with advanced cancer, which should be accounted for in efforts to improve end-of-life care.
AHRQ-funded; HS022998.
Citation: Schuler MS, Joyce NR, Huskamp HA .
Medicare beneficiaries with advanced lung cancer experience diverse patterns of care from diagnosis to death.
Health Aff 2017 Jul;36(7):1193-200. doi: 10.1377/hlthaff.2017.0448..
Keywords: Cancer, Cancer: Lung Cancer, Care Management, Elderly, Medicare, Palliative Care
Meyer 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, 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, 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, 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