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 14 of 14 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, Decision Making
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