
DESCRIPTION
Lung cancer is the most common cause of cancer-related death in the US. Many patients have symptoms for several months before they are diagnosed, resulting in late-stage disease where treatment options are more limited, and patient outcomes are far from ideal.
While we believe there are gaps and potential delays in the diagnostic pathway from first feeling unwell, to being diagnosed, there is not currently much research in the US which has pin-pointed where these gaps/delays in care are. Until we can measure the diagnostic pathway, and find these ‘pain points’, it is difficult to improve care.
This project aims to develop and test a clinical quality measure for lung cancer diagnosis using electronic medical record (EMR) data from UW Medicine. The quality measure will incorporate three metrics to lung cancer diagnosis. 1) Time intervals within the diagnostic pathway, including from patients first reporting symptoms, to their initial clinical presentation, to definitive histological diagnosis; 2) measurement of patient centered outcomes of testing, and 3) efficiency of the testing process.
We have identified a cohort of individuals who were diagnosed with lung cancer over a ten year period, and will use both coded data (e.g. diagnostic codes, procedures codes), as well as natural language processing of free text in clinical notes, to identify symptoms, tests, referrals, and populate a timeline of diagnosis and efficiencies of testing.

WHAT IS THE POTENTIAL IMPACT ON PRIMARY CARE?
Most patients who are diagnosed with lung cancer are seen at some point in their diagnostic journey in primary care or ED settings. However, identifying them can be very challenging. This work will help to identify where there are potential gaps or delays in care, so that we can design interventions to improve the timeliness and efficiency of diagnosis of lung cancer.

WHAT IS PCI-LAB DOING?
Dr. Thompson is the Primary Investigator of this study, and leading the research on this innovative study of lung cancer diagnosis.
Resources
Unmet needs and opportunities for improving care for patients with advanced lung cancer on targeted therapies: a qualitative study. Al Achkar M, Marchand L, Thompson M, Chow LQM, Revere D, Baldwin LM.BMJ Open. 2020 Mar 23;10(3):e032639. doi: 10.1136/bmjopen-2019-032639.