Abstract
Objective: This research describes the clinical pathway and characteristics of patients with and without a lung cancer diagnosis from identification of a solitary pulmonary nodule (SPN) through diagnosis or 1 year follow-up using linked data from an electronic medical record and the Louisiana Tumor Registry. Materials and Methods: REACHnet is one of 9 clinical research networks (CRNs) in PCORnet®, the National Patient-Centered Clinical Research Network and includes electronic health records for over 8 million patients from multiple partner health systems. Data from Ochsner Health System and Tulane Medical Center were linked to Louisiana Tumor Registry (LTR), a statewide population-based cancer registry, for analysis of patient’s clinical pathways between July 2013 and 2017. Patient characteristics and health services utilization rates by cancer stage were reported as frequency distributions. The Kaplan-Meier product limit method was used to estimate the time from index date to diagnosis by stage in lung cancer cohort. Results: A total of 30,559 potentially eligible patients were identified and 2,929 (9.58%) had primary lung cancer. Of these, 1,496 (51.1%) were documented in LTR and their clinical pathway to diagnosis was further studied. Time to diagnosis varied significantly by cancer stage. A total of 24,140 patients with an SPN were identified in REACHnet and 15,978 (66.6%) had documented follow up care for one year. 1,612 (10%) had no evidence of any work up for their SPN. The remaining 14,366 had some evidence of follow up, primarily office visits and additional chest imaging. Conclusion: In both populations multiple biopsies were evident in the clinical pathway. Despite clinical workup, 70% of patients in the diagnosed population had stage III or IV disease. In the non-diagnosed population, only 66% received follow up care for their SPN diagnosis.
1345P Using social listening to understand stakeholder perceptions of the patient journey in lung cancer
