ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2024
Development and Implementation of a Digital Quality Measure of Emergency Cancer Diagnosis.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Article
- Mortality after emergency presentation: evidence from a cohort of 929 378 Medicare beneficiaries with common cancers diagnosed 2008-2017.Journal of the National Cancer Institute · 2026Article
- Digital quality measure of potentially avoidable emergency presentations among patients with colorectal cancer.BMJ quality & safety · 2026Article
- Surveying patients to assess timeliness of cancer diagnosis.Diagnosis (Berlin, Germany) · 2026Article
- A digital quality measure for emergency presentation of pancreatic cancer.British journal of cancer · 2026Article
- Emergency cancer diagnosis in older adults: patterns, subgroups, and implications for health-care quality metrics.JNCI cancer spectrum · 2026Article
- Letter to the Editor in response to "Application of a digital quality measure for cancer diagnosis in Epic Cosmos".Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Emergency Department Use Prior to Cancer Diagnosis and Mortality.JAMA network open · 2025Article
- Registry versus claims-based index dates for studies of cancer diagnosis in administrative data.Cancer causes & control : CCC · 2025Article
- Application of a digital quality measure for cancer diagnosis in Epic Cosmos.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Proportion trends, cancer stage, and survival of patients with cancer diagnosed through emergency and nonemergency departments: a nationwide cohort study.Frontiers in oncology · 2024Article
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13 authors.
Funding
Abstract
purposeMissed and delayed cancer diagnoses are common, harmful, and often preventable. Automated measures of quality of cancer diagnosis are lacking but could identify gaps and guide interventions. We developed and implemented a digital quality measure (dQM) of cancer emergency presentation (EP) using electronic health record databases of two health systems and characterized the measure's association with missed opportunities for diagnosis (MODs) and mortality.
methodsOn the basis of literature and expert input, we defined EP as a new cancer diagnosis within 30 days after emergency department or inpatient visit. We identified EPs for lung cancer and colorectal cancer (CRC) in the Department of Veterans Affairs (VA) and Geisinger from 2016 to 2020. We validated measure accuracy and identified preceding MODs through standardized chart review of 100 records per cancer per health system. Using VA's longitudinal encounter and mortality data, we applied logistic regression to assess EP's association with 1-year mortality, adjusting for cancer stage and demographics.
resultsAmong 38,565 and 2,914 patients with lung cancer and 14,674 and 1,649 patients with CRCs at VA and Geisinger, respectively, our dQM identified EPs in 20.9% and 9.4% of lung cancers, and 22.4% and 7.5% of CRCs. Chart reviews revealed high positive predictive values for EPs across sites and cancer types (72%-90%), and a substantial percent represented MODs (48.8%-84.9%). EP was associated with significantly higher odds of 1-year mortality for lung cancer and CRC (adjusted odds ratio, 1.78 and 1.83, respectively, 95% CI, 1.63 to 1.86 and 1.61 to 2.07).
conclusionA dQM for cancer EP was strongly associated with both mortality and MODs. The findings suggest a promising automated approach to measuring quality of cancer diagnosis in US health systems.
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