Evidence map›Paper›PMID 37981476›Full record

ArticleClinical lung cancer2024

Barriers to Timely Lung Cancer Care in Early Stage Non-Small Cell Lung Cancer and Impact on Patient Outcomes.

Mina Pirzadeh, Madeline Lagina, Cameron Wood, Thomas Valley, Nithya Ramnath, Douglas Arenberg, Jane C Deng

Open access · greenAbstract read
In one paragraph

Article in Clinical lung cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Mina PirzadehDivision of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI; Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI. Electronic address: mpirzad@med.umich.edu.
Madeline LaginaDivision of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI; Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI.
Cameron WoodDivision of Hematology and Oncology, Duke University, Durham, NC.
Thomas ValleyDivision of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI; Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI.
Nithya RamnathVeterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI.
Douglas ArenbergDivision of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI.
Jane C DengDivision of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI; Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI.
University of Michigan · USDuke University · US

Funding

Promoting Equity via Change in Practice for Respiratory Failure (PRECIPICE)R01HL157361 · NHLBI · NEW YORK UNIVERSITY · PI ARMSTRONG-HOUGH, MARI, VALLEY, THOMAS SEBASTIAN · 2022 to 2025
$2.7M
Preventing avoidable deaths from pneumonia by improving use of intensive careK23HL140165 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI VALLEY, THOMAS SEBASTIAN · 2018 to 2022
$915k
NHLBI NIH HHS K23 HL140165NHLBI NIH HHS R01 HL157361
6 · The paper itself

Abstract

backgroundOptimal time to treatment for early-stage lung cancer is uncertain. We examined causes of delays in care for Veterans who presented with early-stage non-small cell lung cancer (NSCLC) and whether workup time was associated with increased upstaging or all-cause mortality.

methodsWe performed a retrospective analysis of Veterans referred to our facility with radiographic stage I or II NSCLC between January 2013 to December 2017, with follow-up through October 2021. Patient demographics, tumor characteristics, time intervals of care, and reasons for delays were collected. Guideline concordance (GC) was defined as treatment within 14 weeks of abnormal image. Multivariable analyses were performed to determine association between delays in care, survival, and upstaging.

resultsData from 203 Veterans were analyzed. Median time between abnormal imaging to treatment was 17.7 weeks (IQR 12.7-26.6). Only 33% of Veterans received GC care. Most common patient-related delays were: intercurrent hospitalization/comorbidity (23%), no-shows (16%) and inability to reach Veteran (17%). Most common system-related delay: lack of scheduling availability (25%). Delays associated with upstaging: transportation issues, request for coordination of appointments, and unforeseen appointment changes. Rates of upstaging did not differ between GC and discordant groups (P = .6). GC care was not an independent predictor of mortality. Post-hoc, treatment within 8 weeks was associated with lower rates of upstaging (P = .05).

conclusionAlthough GC care did not impact survival or upstaging for early-stage NSCLC, shorter timeframes may be beneficial. Modifiable delays in care exist which may be addressed at an institutional level to improve timeliness of care.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsSmall Cell Lung CarcinomaHumansNeoplasm StagingRetrospective StudiesEvidence-based medicineOncologyQuality improvementSmoking

Identifiers

PMID37981476
PMCPMC10922667
OpenAlexW4388067949

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.