Evidence map›Paper›PMID 39375035›Full record

ArticleHealth services research2025

"We don't get that information right back to us unless it's a full-blown cancer": Challenges coordinating lung cancer screening across healthcare systems.

Rendelle E Bolton, Eduardo R Núñez, Jacqueline Boudreau, Lauren M Kearney, Samantha K Ryan, Abigail Herbst, Christopher Slatore, Renda Soylemez Wiener

Abstract read
In one paragraph

Article in Health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. 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

8 authors.

Rendelle E BoltonVA Bedford Healthcare System, Center for Healthcare Organization and Implementation Research, Bedford, Massachusetts, USA.ORCID https://orcid.org/0000-0003-1621-8277
Eduardo R NúñezVA Boston Healthcare System, Center for Healthcare Organization and Implementation Research, Boston, Massachusetts, USA.
Jacqueline BoudreauVA Bedford Healthcare System, Center for Healthcare Organization and Implementation Research, Bedford, Massachusetts, USA.
Lauren M KearneyVA Boston Healthcare System, Center for Healthcare Organization and Implementation Research, Boston, Massachusetts, USA.
Samantha K RyanVA Boston Healthcare System, Center for Healthcare Organization and Implementation Research, Boston, Massachusetts, USA.
Abigail HerbstVA Bedford Healthcare System, Center for Healthcare Organization and Implementation Research, Bedford, Massachusetts, USA.
Christopher SlatoreCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, USA.
Renda Soylemez WienerVA Boston Healthcare System, Center for Healthcare Organization and Implementation Research, Boston, Massachusetts, USA.

Funding

BIOLOGY OF THE LUNG--MULTIDISCIPLINARY PROGRAMT32HL007035 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Darrell N. Kotton, JOSEPH P MIZGERD · 1985 to 2026
$24.3M
NHLBI NIH HHS T32 HL007035US Department of Veterans Affairs Health Services Research and Development IIR #18-075
6 · The paper itself

Abstract

objectiveTo examine how lung cancer screening (LCS) is coordinated across healthcare systems, specifically Veterans Affairs (VA) and non-VA settings. DATA SOURCES AND STUDY

settingWe conducted primary qualitative data collection in six VA medical centers with established LCS programs from November 2020 to November 2021. STUDY DESIGN AND DATA COLLECTION

methodsSemi-structured interviews were conducted with 48 primary care providers, LCS program coordinators and directors, and pulmonologists. Thematic analysis examined spontaneously raised narratives related to initiating and coordinating LCS for Veterans screened in non-VA settings. We mapped coordination challenges to each step of the LCS care continuum. PRINCIPAL

findingsWhile non-VA options increased access to LCS for Veterans, VA medical centers lacked clear processes for initiating LCS referrals and tracking Veterans across the LCS continuum when screening occurred in non-VA settings. The responsibility of coordinating LCS with community providers often fell to VA primary care providers rather than LCS programs. Gaps in communication and data transfer contributed to delayed evaluation of potentially cancerous nodules post-screening, raising concerns about compromised care quality when LCS was shared with non-VA settings.

conclusionsWhile policies expanding LCS for Veterans in non-VA settings increase access, lack of consistent processes to initiate referrals, obtain results, and promote timely downstream evaluation fragmented care and delayed evaluation of concerning nodules. These unintended consequences highlight a need to address cross-system coordination challenges. Strategies to better coordinate LCS between VA and non-VA settings are essential to achieve high quality LCS and prevent Veterans from falling through the cracks.

Indexed as

Early Detection of CancerLung NeoplasmsMass ScreeningContinuity of Patient CareHumansInterviews as TopicMalePrimary Health CareQualitative ResearchUnited StatesUnited States Department of Veterans AffairsVeteranscare coordinationhealth systemslung cancer screeningpatient‐centered careprimary carequalitative researchVeterans

Identifiers

PMID39375035
PMCPMC11782077

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.