Lung Cancer
Conditions
Brief summary
Lung cancer kills 160,000 patients annually; this represents 28% of all US cancer deaths. The overall year survival rate has only improved from 12% to 17% in 33 years. This failure reflects the innate lethality of lung cancer, but also reflects defects in patient care delivery. Care for the lung cancer patient starts with an abnormal radiologic scan, proceeds through a diagnostic biopsy, tests to determine the extent of spread of the disease (stage), selection of appropriate treatment, and finally ends with patient outcomes. At each step are multiple options and independent specialists, each one engaged by a process of sequential referrals in the serial care model. This process is often not user-friendly, is riddled with inefficiency, delays, and outcome variances. The coordinated multidisciplinary model, in which patients and their doctors collaborate to provide evidence-based care, is believed by experts to be superior, but has few examples of successful implementation. The implementation gap exists because of the paucity of good quality data, and lack of implementation know-how. Embedded in the highest US lung cancer mortality zone, the greater Memphis area has a racially, culturally, economically and geographically diverse population. The investigators research group has shown how poor quality care impairs patient survival in this region and in the greater US. The investigators have linked patient survival to compliance with multidisciplinary care plans. In this project, the investigators propose to rigorously test the impact of the multidisciplinary care model on patient outcomes in a community-based, private practice environment, similar to where 70% of lung cancer care is delivered in the US. The objective of this study is to provide high-level evidence of the impact of multidisciplinary care on lung cancer patient outcomes. Multidisciplinary care is defined as a model of care in which patients, their care-givers and key specialists concurrently and directly evaluate the same patients in the presence of the patients and their informal caregivers, in order to develop evidence-based consensus care plans
Detailed description
Within the Baptist Memorial Health Care system, the Multidisciplinary Thoracic Oncology Program has two components: Primarily, the program is centered in a multidisciplinary clinic, wherein patients and their informal caregivers are seen by multiple specialists at a single appointment time; secondarily, the program includes a multidisciplinary conference, wherein all of the specialists potentially involved in lung cancer care discuss patients referred for presentation and make consensus recommendations for care. This study focuses primarily on the experience and outcomes of care delivered to patients evaluated in the multidisciplinary clinic. However, data from the conference will also be included in some aspects of the study. The goal is to improve the access and quality of thoracic oncologic care delivery within the Baptist Healthcare System The investigators specific aim is to perform a prospective, matched cohort comparative effectiveness study of patients receiving serial vs. multidisciplinary care, with key patient-centered endpoints (survival, stakeholder satisfaction with the care experience, timeliness and stage-appropriateness of care, quality of staging). Serial care is defined as the current system of linear, sequential, referral-based care delivery.
Interventions
None listed
Sponsors
Patient-Centered Outcomes Research Institute
Baptist Memorial Health Care Corporation
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
\- All patients who undergo care for lung cancer or an undiagnosed lung mass within the Baptist Memorial Health Care Corporation's hospitals from January 1, 2009 until the end of the defined study period will be eligible for inclusion in the data collection for this study. In addition, caregivers of patients within the same institution and within the study window, clinical care providers (doctors and nurses) who have taken care of patients within the eligible institutions during the study window.
Exclusion criteria
* Patients who do not have a radiology-identified lung lesion or lung cancer are excluded from this study. * Patients not receiving care within the Baptist Memorial Healthcare Corporation are excluded from this study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Thoroughness of Invasive Staging, Multidisciplinary (MD) vs Serial Care (SC) | From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months | Number of patients with a test that provides tissue confirmation of the stage-defining lesion. Tests include a biopsy of any identified suspicious metastatic lesion or the primary lesion in the absence of any other suspicious lesion. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. |
| Thoroughness of Invasive Mediastinal Staging, MD vs SC | From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months | Number of patients with a test (i.e., biopsy) that provides tissue confirmation of the presence or absence of mediastinal nodal metastasis. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. |
| Thoroughness of Bi-Modal Staging Practice, MD vs SC | From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months | Number of patients receiving two forms of staging tests (bi-modal staging). Bi-modal staging is defined as a CT scan plus any other type of radiologic scan or any biopsy. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. |
| Thoroughness of Tri-Modal Staging Practice, MD vs SC | From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months | Number of patients receiving three forms of staging tests (tri-modal staging). Tri-modal staging is defined as a CT scan plus any other type of radiologic scan plus any biopsy, or PET/CT plus any biopsy. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. |
| Thoroughness of Invasive Staging, MD vs SC (Conference) vs SC (no Conference) | From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months | Number of patients with a test that provides tissue confirmation of the stage-defining lesion. Tests include a biopsy of any identified suspicious metastatic lesion or the primary lesion in the absence of any other suspicious lesion. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model. |
| Thoroughness of Invasive Mediastinal Staging, MD vs SC (no Conference) vs SC (Conference) | From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months | Number of patients with a test (i.e., biopsy) that provides tissue confirmation of the presence or absence mediastinal nodal metastasis. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model. |
| Thoroughness of Bi-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months | Number of patients receiving two forms of staging tests (bi-modal staging). Bi-modal staging is defined as a CT scan plus any other type of radiologic scan or any biopsy. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model. |
| Thoroughness of Tri-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months | Number of patients receiving three forms of staging tests (tri-modal staging). Tri-modal staging is defined as a CT scan plus any other type of radiologic scan plus any biopsy, or PET/CT plus any biopsy. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model. |
| Stage-Appropriateness Treatment Selection, MD vs SC | From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months | Number of patients for whom appropriate treatment was given, as determined by the patients' clinical stage and treatment guidelines stipulated by the National Comprehensive Cancer Network (NCCN). 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. For Stage I or II: surgery (or radiation therapy with documented contraindication to surgery or patient refusal); for Stage III: chemotherapy and radiation therapy with or without surgery; for Stage IV: systemic therapy (or palliative care with documented patient refusal or contraindication to systemic therapy). |
| Stage-Appropriateness Treatment Selection, MD vs SC (Conference) vs SC (no Conference) | From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months | Number of patients for whom appropriate treatment was given, as determined by the patients' clinical stage and treatment guidelines stipulated by the National Comprehensive Cancer Network (NCCN). For Stage I or II: surgery (or radiation therapy with documented contraindication to surgery or patient refusal); for Stage III: chemotherapy and radiation therapy with or without surgery; for Stage IV: systemic therapy (or palliative care with documented patient refusal or contraindication to systemic therapy). This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model. |
| Timeliness of Communication, MD vs SC(Conference) | Within 48 hours of a documented care recommendation made through the multidisciplinary thoracic oncology program | Number of patients for whom formal, verified communication of care management decisions was made to all team members (providers inside and outside the multidisciplinary program, patients and their care-givers) within 48 hours of a care recommendation being made. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. |
| Concordance Rate for Initial Conference Recommendations, MD vs SC (Conference) | From the time of a patient's positive lung cancer diagnosis, to the end of a patient's last line of treatment, an average of 1-2 months | Number of patients for whom all recommendations made at the initial multidisciplinary conference were completed. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. Note that two patients (one from the MD arm and one from the SC arm) have died before receiving recommendations and therefore were not analyzed for this outcome. |
| Concordance Rate for Initial Conference Recommendation(s) With Prior Condition Met, MD vs SC (Conference) | From the time of a patient's positive lung cancer diagnosis, to the end of a patient's last line of treatment, an average of 1-2 months | Number of patients for whom all initial conference recommendations were completed, excluding conditional recommendations for which the prior condition was not met. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. Note that two patients (one from the MD arm and one from the SC arm) have died before receiving recommendations and therefore were not analyzed for this outcome. E.g., if a recommendation was to have a PET/CT and then a staging biopsy if the PET showed suspicious metastatic disease, the staging biopsy recommendation was excluded from the concordance measure if the PET/CT did not happen or was negative. |
| Concordance Rate for Any Conference Recommendation, MD vs SC (Conference) | From the time of a patient's positive lung cancer diagnosis, to the end of a patient's last line of treatment, an average of 1-2 months | Number of patients for whom any initial conference recommendation was completed. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. Note that two patients (one from the MD arm and one from the SC arm) have died before receiving recommendations and therefore were not analyzed for this outcome. |
| Overall Concordance Rate Using a Hierarchy of Initial Conference Recommendations, MD vs SC (Conference) | From the time of a patient's positive lung cancer diagnosis, to the end of a patient's last line of treatment, an average of 1-2 months | Number of patients for whom the overall initial conference recommendation was completed. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. Note that two patients (one from the MD arm and one from the SC arm) have died before receiving recommendations and therefore were not analyzed for this outcome. The hierarchy to rank recommendations, from highest priority to lowest, was (1) treatment, (2) staging, (3) diagnosis, (4) surveillance. If a patient had a treatment recommendation and it happened, he/she was concordant. If treatment was recommended and it did not happen, he/she was discordant. If no treatment recommendation was made, then concordance was measured by whether or not the staging recommendation was met. If no staging recommendation was made, then the diagnostic recommendation was given priority for a concordance measurement. If no diagnostic recommendation, then a surveillance recommendation was used to measure overall concordance. |
| Concordance Rate for Treatment Recommendations With Prior Recommendations Completed, MD vs SC (Conference) | From the time of a patient's positive lung cancer diagnosis, to the end of a patient's last line of treatment, an average of 1-2 months | Number of patients for whom the treatment recommendation made at the initial conference presentation was completed, excluding any patient for whom prior recommendations (staging, diagnosis, surveillance) were not also completed. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. |
| Baseline Patient Survey Response Rate, MD vs SC | Baseline | Number of patients who completed a baseline patient survey |
| 3-month Patient Survey Response Rate, MD vs SC | Within 30 days of 3 months after baseline survey administration | Number of patients who completed a 3-month survey |
| 6-Month Patient Survey Response Rate, MD vs SC | Within 30 days of 6 months after baseline survey administration | Number of patients who completed a 6-month survey |
| Patient Survey Scores at Baseline, MD vs SC | Baseline | Scores from patient surveys that measure quality of life and satisfaction with care received at the time the baseline survey was taken. Overall quality of health care - satisfaction with overall quality of health care since lung cancer diagnosis; range: 0-4 (higher is better) Financial burden of care - assessment of financial burden of care; range: 3-6 (sum of 3 items, higher is worse) Treatment decision-making: Surgery/Radiation/Chemotherapy - each 1 item; satisfaction with treatment decision-making; range: 0-2 (0=patient controlled; 1=shared decision; 2-physician decision; closer to 1 is best) Satisfaction with treatment plan - satisfaction with overall treatment plan; range: 1-5 (sum of 2 items, higher is better) Treatment decision-making: family role - satisfaction with family role in treatment decision-making; range: 0-2 (0=patient controlled; 1=shared decision; 2-physician decision; closer to 1 is best) (descriptions continued in 3 month survey description) |
| Patient Survey Scores at 3 Months, MD vs SC | Within 30 days of 3 months after baseline survey administration | Scores from patient surveys that measure quality of life and satisfaction with care received at the time the 3-month survey was taken. (continued from baseline) Satisfaction with quality of care - overall satisfaction with care received from all care team members; range: 0-18 (sum of 6 items, higher is better) Satisfaction with physician communication - overall satisfaction with physician communication; range: 0-21 (sum of 7 items, higher is better) Satisfaction with nurse communication - overall satisfaction with nurse communication; range: 0-18 (sum of 6 items, higher is better) Overall team satisfaction - CAHPS satisfaction with care from team as a whole; range: 0-15 (sum of 4 items, higher is better) Physical/Social/Functional well-being - health-related quality of life relating to physical/social/functional well-being; range 0-28 (each a sum of 7 items, higher is better) (description continues in 6 month survey description) |
| Patient Survey Scores at 6 Months, MD vs SC | Within 30 days of 6 months after baseline survey administration | Scores from patient surveys that measure quality of life and satisfaction with care received at the time the 6-month survey was taken. (cont) Emotional well-being - health-related quality of life related to emotional well-being; range 0-30 (sum of 6 items, higher is better) Lung cancer specific QOL - health-related quality of life related to lung cancer diagnosis; range: 0-36 (sum of 9 items, higher is better) Total Summary Score FACTL - full survey, functional assessment of cancer therapy - lung; range: 0-136 (sum of 36 items, higher is better) Generic Score FACTG - full survey, functional assessment of cancer therapy - general; range: 0-108 (sum of 27 items, higher is better) Trial Outcome Index - health related quality of life - trial outcome index; range: 0-84 (sum of 23 items, higher is better) Depression/Anxiety - depression/anxiety measured by Hospital Anxiety and Depression Scale; range: 0-21 (sum of 7 items each, higher is worse) |
| Baseline Caregiver Survey Response Rate, MD vs SC | Baseline | Number of caregivers who completed a baseline patient survey |
| 3-month Caregiver Survey Response Rate, MD vs SC | Within 30 days of 3 months after baseline survey administration | Number of caregivers who completed a 3-month survey |
| 6-Month Caregiver Survey Response Rate, MD vs SC | Within 30 days of 6 months after baseline survey administration | Number of caregivers who completed a 6-month survey |
| Caregiver Survey Scores at Baseline, MD vs SC | Baseline | Scores from caregiver surveys that measure quality of life and satisfaction with care received at the time the baseline survey was taken. Overall quality of health care - satisfaction with overall quality of health care since lung cancer diagnosis; range:0-4 (higher is better) Treatment decision-making: Surgery/Radiation/Chemotherapy - each 1 item; satisfaction with treatment decision-making; range: 0-2 (0=patient controlled; 1=shared decision; 2-physician decision; closer to 1 is best) Treatment decision-making: family role - satisfaction with family role in treatment decision-making; range: 0-2 (0=patient controlled; 1=shared decision; 2-physician decision; closer to 1 is best) Satisfaction with treatment plan - satisfaction with overall treatment plan; range: 0-2 (higher is better) Satisfaction patient can complete treatment plan; range: 0-2 (higher is better) (continued in 3 month survey description) |
| Patient Disease/Progression Free Survival | measured from the time from cancer diagnosis to disease progression, death, or data censoring, up to 6 years | Event-free survival (EFS), as measured from the time from cancer diagnosis to disease progression, death, or data censoring, is analyzed and summarized with the survival probabilities over time using the Kaplan-Meier method. Confidence intervals for the 1- and 3- year survival probabilities are reported. Additionally, the Cox proportional hazard model was used to estimate hazard ratios which are reported in the statistical analyses with 95% confidence intervals. |
| Caregiver Survey Scores at 3 Months, MD vs SC | Within 30 days of 3 months after baseline survey administration | Scores from caregiver surveys that measure quality of life and satisfaction with care received at the time the 3-month survey was taken. (cont) Satisfaction with quality of care - overall satisfaction with care received from all care team members; range: 0-18 (sum of 6 items, higher is better) Satisfaction with physician communication - overall satisfaction with physician communication; range: 0-28 (sum of 7 items, higher is better) Satisfaction with nurse communication - overall satisfaction with nurse communication; range: 6-24 (sum of 6 items, higher is better) Overall team satisfaction - CAHPS satisfaction with care from team as a whole; range: 0-15 (sum of 4 items, higher is better) Depression/Anxiety - depression/anxiety measured by Hospital Anxiety and Depression Scale; range: 0-21 (sum of 7 items, higher is worse) (continued in 6 month survey description) |
| Caregiver Survey Scores at 6 Months, MD vs SC | Within 30 days of 6 months after baseline survey administration | Scores from caregiver surveys that measure quality of life and satisfaction with care received at the time the 6-month survey was taken. (cont) Physical Functioning QOL - 10 items; Physical Health Problems QOL - 4 items; Pain QOL - 2 items; General health perceptions - 5 items; Energy/fatigue QOL - 4 items; Social Functioning QOL - 2 items; Emotional health problems QOL - 3 items; Emotional well-being QOL - 5 items. All health related quality of life measures are from the SF-36 survey tool, and use a range of 0-100 mean score (higher is better). |
| Timeliness of Care, MD vs SC | From the time of a patient's initial lesion detection to the designated step in the care process, as noted per row below | Aggregate time in days from enrollment to a specific care delivery endpoint including: from initial detection of lesion to initial biopsy, from initial detection to non-invasive staging, from initial detection to invasive staging, and from initial detection to definitive treatment. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. |
| Timeliness of Care, MD vs SC (Conference) vs SC (no Conference) | From the time of a patient's initial lesion detection to the designated step in the care process, as noted per row below | Aggregate time in days from enrollment to specific care delivery endpoint including: from initial detection of lesion to initial biopsy, from initial detection to non-invasive staging, from initial detection to invasive staging, and from initial detection to definitive treatment. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model. |
| Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | After a provider referred their 5th patient to the multidisciplinary conference (baseline), then within 30 days of 6 months and 12 months, respectively, after baseline survey was completed | Responses from clinical providers will measure provider satisfaction and obstacles to institutional multidisciplinary care. |
| Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | After a provider referred their 5th patient to the multidisciplinary conference (baseline), then within 30 days of 6 months and 12 months, respectively, after baseline survey was completed | Responses from clinical providers will measure provider satisfaction and obstacles to institutional multidisciplinary care. |
| Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | After a provider referred their 5th patient to the multidisciplinary conference (baseline), then within 30 days of 6 months and 12 months, respectively, after baseline survey was completed | Responses from clinical providers will measure provider satisfaction and obstacles to institutional multidisciplinary care. |
| Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | After a provider referred their 5th patient to the multidisciplinary conference (baseline), then within 30 days of 6 months and 12 months, respectively, after baseline survey was completed | Responses from clinical providers will measure provider satisfaction and obstacles to institutional multidisciplinary care. |
| Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | After a provider referred their 5th patient to the multidisciplinary conference (baseline), then within 30 days of 6 months and 12 months, respectively, after baseline survey was completed | Responses from clinical providers will measure provider satisfaction and obstacles to institutional multidisciplinary care. |
| Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | After a provider referred their 5th patient to the multidisciplinary conference (baseline), then within 30 days of 6 months and 12 months, respectively, after baseline survey was completed | Responses from clinical providers will measure provider satisfaction and obstacles to institutional multidisciplinary care. |
| Patient Overall Survival | As measured from the time from cancer diagnosis to death or data censor, up to 6 years | Overall survival, defined as the time from cancer diagnosis to death from any cause or data censoring, is analyzed and summarized with the survival probabilities over time using the Kaplan-Meier method. Confidence intervals for the 1- and 3- year survival probabilities are reported. Additionally, the Cox proportional hazard model was used to estimate hazard ratios which are reported in the statistical analyses with 95% confidence intervals. |
| Patient Overall Survival With SC Further Broken Down | As measured from the time from cancer diagnosis to death or data censor, up to 6 years | Overall survival, defined as the time from cancer diagnosis to death from any cause or data censoring, is analyzed and summarized with the survival probabilities over time using the Kaplan-Meier method. Confidence intervals for the 1- and 3- year survival probabilities are reported. Additionally, the Cox proportional hazard model was used to estimate hazard ratios which are reported in the statistical analyses with 95% confidence intervals. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model. |
| Patient Disease/Progression Free Survival With SC Further Broken Down | As measured from the time from cancer diagnosis to death or data censor, up to 6 years | Event-free survival (EFS), as measured from the time from cancer diagnosis to disease progression, death, or data censoring, is analyzed and summarized with the survival probabilities over time using the Kaplan-Meier method. Confidence intervals for the 1- and 3- year survival probabilities are reported. Additionally, the Cox proportional hazard model was used to estimate hazard ratios which are reported in the statistical analyses with 95% confidence intervals. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model. |
Countries
United States
Participant flow
Recruitment details
The recruitment process included a patient population of those receiving care and/or treatment for their lung cancer from physicians and clinics within the Baptist Cancer Center network, including sites in the Memphis metropolitan area, Oxford, Mississippi, and Jonesboro, Arkansas. Dates of recruitment were from October 2014 through May 2016.
Pre-assignment details
Patient eligibility criteria: diagnosis of lung cancer within 6 weeks of screening date, an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2, no previous lung cancer diagnosis, and no diagnosis of other cancers within the past 5 years. Caregivers and clinical care providers (doctors/nurses) of eligible patients also gave consent.
Participants by arm
| Arm | Count |
|---|---|
| Multidisciplinary Clinic Patients 150 multidisciplinary clinic patients and their informal caregivers are seen by multiple specialists at a single appointment time. | 178 |
| Serial Care Patients 300 matched serial care control patients who receive the current system of linear, sequential, referral-based care delivery. | 348 |
| Total | 526 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 |
|---|---|---|---|---|---|---|
| 3-month Follow up (Cumulative Counts) | Death | 33 | 57 | 0 | 0 | 0 |
| 3-month Follow up (Cumulative Counts) | Lost to Follow-up | 2 | 7 | 50 | 82 | 3 |
| 3-month Follow up (Cumulative Counts) | Out of window for follow-up survey | 16 | 36 | 0 | 0 | 0 |
| 3-month Follow up (Cumulative Counts) | Relocation | 0 | 1 | 0 | 0 | 0 |
| 3-month Follow up (Cumulative Counts) | Withdrawal by Subject | 6 | 16 | 0 | 0 | 0 |
| 6-month Follow up (Cumulative Counts) | Death | 51 | 97 | 0 | 0 | 0 |
| 6-month Follow up (Cumulative Counts) | Lost to Follow-up | 3 | 20 | 66 | 113 | 3 |
| 6-month Follow up (Cumulative Counts) | Relocation | 0 | 2 | 0 | 0 | 0 |
| 6-month Follow up (Cumulative Counts) | Withdrawal by Subject | 1 | 9 | 0 | 0 | 0 |
| Baseline Intervention | Death | 9 | 16 | 0 | 0 | 0 |
| Baseline Intervention | Lost to Follow-up | 0 | 5 | 0 | 0 | 0 |
| Baseline Intervention | Other Disease | 3 | 0 | 0 | 0 | 0 |
| Baseline Intervention | Out of window for initial survey | 6 | 13 | 0 | 0 | 0 |
| Baseline Intervention | Relocation | 2 | 0 | 0 | 0 | 0 |
| Baseline Intervention | Withdrawal by Subject | 2 | 8 | 0 | 0 | 0 |
Baseline characteristics
| Characteristic | Total | Multidisciplinary Clinic Patients | Serial Care Patients |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 324 Participants | 123 Participants | 201 Participants |
| Age, Categorical Between 18 and 65 years | 202 Participants | 55 Participants | 147 Participants |
| Age, Continuous | 66.83 Years STANDARD_DEVIATION 9.97 | 68.85 Years STANDARD_DEVIATION 10.34 | 65.79 Years STANDARD_DEVIATION 9.62 |
| ECOG 0 | 198 Participants | 80 Participants | 118 Participants |
| ECOG 1 | 268 Participants | 86 Participants | 182 Participants |
| ECOG 2 | 55 Participants | 12 Participants | 43 Participants |
| ECOG 3 | 5 Participants | 0 Participants | 5 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 12 Participants | 9 Participants | 3 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 472 Participants | 164 Participants | 308 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 42 Participants | 5 Participants | 37 Participants |
| Histology Adenocarcinoma | 263 Participants | 94 Participants | 169 Participants |
| Histology Other | 21 Participants | 9 Participants | 12 Participants |
| Histology Small Cell | 75 Participants | 20 Participants | 55 Participants |
| Histology Squamous Cell | 167 Participants | 55 Participants | 112 Participants |
| Independently Calculated Clinical M Category M0 | 322 Participants | 126 Participants | 196 Participants |
| Independently Calculated Clinical M Category M1a | 47 Participants | 14 Participants | 33 Participants |
| Independently Calculated Clinical M Category M1b | 157 Participants | 38 Participants | 119 Participants |
| Independently Calculated Clinical N Category Insufficient Records | 1 Participants | 0 Participants | 1 Participants |
| Independently Calculated Clinical N Category N0 | 248 Participants | 92 Participants | 156 Participants |
| Independently Calculated Clinical N Category N1 | 42 Participants | 13 Participants | 29 Participants |
| Independently Calculated Clinical N Category N2 | 159 Participants | 46 Participants | 113 Participants |
| Independently Calculated Clinical N Category N3 | 76 Participants | 27 Participants | 49 Participants |
| Independently Calculated Clinical Stage Stage 0 | 1 Participants | 0 Participants | 1 Participants |
| Independently Calculated Clinical Stage Stage IA | 93 Participants | 36 Participants | 57 Participants |
| Independently Calculated Clinical Stage Stage IB | 37 Participants | 13 Participants | 24 Participants |
| Independently Calculated Clinical Stage Stage IIA | 31 Participants | 15 Participants | 16 Participants |
| Independently Calculated Clinical Stage Stage IIB | 27 Participants | 13 Participants | 14 Participants |
| Independently Calculated Clinical Stage Stage IIIA | 89 Participants | 33 Participants | 56 Participants |
| Independently Calculated Clinical Stage Stage IIIB | 44 Participants | 16 Participants | 28 Participants |
| Independently Calculated Clinical Stage Stage IV | 204 Participants | 52 Participants | 152 Participants |
| Independently Calculated Clinical T Category Insufficient Records | 2 Participants | 0 Participants | 2 Participants |
| Independently Calculated Clinical T Category T0 | 5 Participants | 1 Participants | 4 Participants |
| Independently Calculated Clinical T Category T1a | 92 Participants | 35 Participants | 57 Participants |
| Independently Calculated Clinical T Category T1b | 71 Participants | 23 Participants | 48 Participants |
| Independently Calculated Clinical T Category T2a | 116 Participants | 35 Participants | 81 Participants |
| Independently Calculated Clinical T Category T2b | 60 Participants | 20 Participants | 40 Participants |
| Independently Calculated Clinical T Category T3 | 78 Participants | 28 Participants | 50 Participants |
| Independently Calculated Clinical T Category T4 | 102 Participants | 36 Participants | 66 Participants |
| Initial Stage Occult Carcinoma | 2 Participants | 0 Participants | 2 Participants |
| Initial Stage Stage I | 1 Participants | 0 Participants | 1 Participants |
| Initial Stage Stage IA | 95 Participants | 38 Participants | 57 Participants |
| Initial Stage Stage IB | 39 Participants | 13 Participants | 26 Participants |
| Initial Stage Stage II | 1 Participants | 0 Participants | 1 Participants |
| Initial Stage Stage IIA | 33 Participants | 12 Participants | 21 Participants |
| Initial Stage Stage IIB | 33 Participants | 11 Participants | 22 Participants |
| Initial Stage Stage IIIA | 110 Participants | 48 Participants | 62 Participants |
| Initial Stage Stage IIIB | 41 Participants | 17 Participants | 24 Participants |
| Initial Stage Stage IV | 171 Participants | 39 Participants | 132 Participants |
| Primary Insurance Commercial | 213 Participants | 66 Participants | 147 Participants |
| Primary Insurance Medicaid | 110 Participants | 33 Participants | 77 Participants |
| Primary Insurance Medicare | 182 Participants | 69 Participants | 113 Participants |
| Primary Insurance Self-insured/None | 21 Participants | 10 Participants | 11 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 2 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Black or African American | 164 Participants | 65 Participants | 99 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) White | 357 Participants | 110 Participants | 247 Participants |
| Region of Enrollment United States | 526 Participants | 178 Participants | 348 Participants |
| Sex: Female, Male Female | 260 Participants | 93 Participants | 167 Participants |
| Sex: Female, Male Male | 266 Participants | 85 Participants | 181 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 125 / 178 | 239 / 348 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
3-month Caregiver Survey Response Rate, MD vs SC
Number of caregivers who completed a 3-month survey
Time frame: Within 30 days of 3 months after baseline survey administration
Population: Caregivers who completed surveys
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | 3-month Caregiver Survey Response Rate, MD vs SC | Yes | 50 Participants |
| Multidisciplinary Clinic Patients | 3-month Caregiver Survey Response Rate, MD vs SC | No | 50 Participants |
| Serial Care Patients | 3-month Caregiver Survey Response Rate, MD vs SC | Yes | 62 Participants |
| Serial Care Patients | 3-month Caregiver Survey Response Rate, MD vs SC | No | 82 Participants |
Primary
3-month Patient Survey Response Rate, MD vs SC
Number of patients who completed a 3-month survey
Time frame: Within 30 days of 3 months after baseline survey administration
Population: Patients who were offered 3-month surveys.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | 3-month Patient Survey Response Rate, MD vs SC | Yes | 99 Participants |
| Multidisciplinary Clinic Patients | 3-month Patient Survey Response Rate, MD vs SC | No | 57 Participants |
| Serial Care Patients | 3-month Patient Survey Response Rate, MD vs SC | Yes | 189 Participants |
| Serial Care Patients | 3-month Patient Survey Response Rate, MD vs SC | No | 117 Participants |
Primary
6-Month Caregiver Survey Response Rate, MD vs SC
Number of caregivers who completed a 6-month survey
Time frame: Within 30 days of 6 months after baseline survey administration
Population: Caregivers who completed surveys
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | 6-Month Caregiver Survey Response Rate, MD vs SC | Yes | 34 Participants |
| Multidisciplinary Clinic Patients | 6-Month Caregiver Survey Response Rate, MD vs SC | No | 66 Participants |
| Serial Care Patients | 6-Month Caregiver Survey Response Rate, MD vs SC | Yes | 31 Participants |
| Serial Care Patients | 6-Month Caregiver Survey Response Rate, MD vs SC | No | 113 Participants |
Primary
6-Month Patient Survey Response Rate, MD vs SC
Number of patients who completed a 6-month survey
Time frame: Within 30 days of 6 months after baseline survey administration
Population: Patients who were offered 6-month surveys. Note that patients were offered a 6-month survey even if they did not complete a 3-month survey.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | 6-Month Patient Survey Response Rate, MD vs SC | Yes | 101 Participants |
| Multidisciplinary Clinic Patients | 6-Month Patient Survey Response Rate, MD vs SC | No | 55 Participants |
| Serial Care Patients | 6-Month Patient Survey Response Rate, MD vs SC | Yes | 178 Participants |
| Serial Care Patients | 6-Month Patient Survey Response Rate, MD vs SC | No | 128 Participants |
Primary
Baseline Caregiver Survey Response Rate, MD vs SC
Number of caregivers who completed a baseline patient survey
Time frame: Baseline
Population: Caregivers who completed surveys
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Baseline Caregiver Survey Response Rate, MD vs SC | No | 0 Participants |
| Multidisciplinary Clinic Patients | Baseline Caregiver Survey Response Rate, MD vs SC | Yes | 100 Participants |
| Serial Care Patients | Baseline Caregiver Survey Response Rate, MD vs SC | Yes | 144 Participants |
| Serial Care Patients | Baseline Caregiver Survey Response Rate, MD vs SC | No | 0 Participants |
Primary
Baseline Patient Survey Response Rate, MD vs SC
Number of patients who completed a baseline patient survey
Time frame: Baseline
Population: Patients who were offered baseline surveys (all Specific Aim 3 patients)
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Baseline Patient Survey Response Rate, MD vs SC | Yes | 156 Participants |
| Multidisciplinary Clinic Patients | Baseline Patient Survey Response Rate, MD vs SC | No | 22 Participants |
| Serial Care Patients | Baseline Patient Survey Response Rate, MD vs SC | Yes | 306 Participants |
| Serial Care Patients | Baseline Patient Survey Response Rate, MD vs SC | No | 42 Participants |
Primary
Caregiver Survey Scores at 3 Months, MD vs SC
Scores from caregiver surveys that measure quality of life and satisfaction with care received at the time the 3-month survey was taken. (cont) Satisfaction with quality of care - overall satisfaction with care received from all care team members; range: 0-18 (sum of 6 items, higher is better) Satisfaction with physician communication - overall satisfaction with physician communication; range: 0-28 (sum of 7 items, higher is better) Satisfaction with nurse communication - overall satisfaction with nurse communication; range: 6-24 (sum of 6 items, higher is better) Overall team satisfaction - CAHPS satisfaction with care from team as a whole; range: 0-15 (sum of 4 items, higher is better) Depression/Anxiety - depression/anxiety measured by Hospital Anxiety and Depression Scale; range: 0-21 (sum of 7 items, higher is worse) (continued in 6 month survey description)
Time frame: Within 30 days of 3 months after baseline survey administration
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Surgery | 0.71 scores on a scale | Standard Error 0.69 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Depression | 3.72 scores on a scale | Standard Error 3.1 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Family role | 0.64 scores on a scale | Standard Error 0.53 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Anxiety | 6.20 scores on a scale | Standard Error 4.1 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Satisfaction with treatment plan | 1.80 scores on a scale | Standard Error 0.49 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Physical Functioning QOL | 76.92 scores on a scale | Standard Error 26.13 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Satisfaction patient can complete treatment plan | 1.86 scores on a scale | Standard Error 0.42 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Physical health problems QOL | 68.37 scores on a scale | Standard Error 38.79 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Radiation | 0.90 scores on a scale | Standard Error 0.6 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Pain QOL | 68.37 scores on a scale | Standard Error 38.79 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Satisfaction with quality of care | 16.82 scores on a scale | Standard Error 2.14 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | General health perceptions | 73.90 scores on a scale | Standard Error 20.16 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Satisfaction with physician communication | 19.30 scores on a scale | Standard Error 1.63 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Energy/Fatigue QOL | 57.70 scores on a scale | Standard Error 18.3 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Overall quality of health care | 3.32 scores on a scale | Standard Error 0.96 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Social Functioning QOL | 73.60 scores on a scale | Standard Error 27.08 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Satisfaction with nurse communication | 23.36 scores on a scale | Standard Error 1.66 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Emotional health problems QOL | 62.67 scores on a scale | Standard Error 40.76 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Chemo | 0.78 scores on a scale | Standard Error 0.64 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Emotional well-being QOL | 68.37 scores on a scale | Standard Error 14.61 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Overall team satisfaction | 11.52 scores on a scale | Standard Error 0.89 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Emotional well-being QOL | 67.80 scores on a scale | Standard Error 20.82 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Satisfaction with treatment plan | 1.81 scores on a scale | Standard Error 0.44 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Satisfaction with quality of care | 14.54 scores on a scale | Standard Error 2.38 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Surgery | 1.08 scores on a scale | Standard Error 0.65 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Radiation | 1.00 scores on a scale | Standard Error 0.58 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Chemo | 1.13 scores on a scale | Standard Error 0.58 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Family role | 0.75 scores on a scale | Standard Error 0.48 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Satisfaction patient can complete treatment plan | 1.89 scores on a scale | Standard Error 0.32 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Satisfaction with physician communication | 19.22 scores on a scale | Standard Error 2.45 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Satisfaction with nurse communication | 23.28 scores on a scale | Standard Error 2.59 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Overall team satisfaction | 11.46 scores on a scale | Standard Error 1.13 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Depression | 3.04 scores on a scale | Standard Error 3.1 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Anxiety | 6.04 scores on a scale | Standard Error 5.05 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Physical Functioning QOL | 73.67 scores on a scale | Standard Error 27.78 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Physical health problems QOL | 63.43 scores on a scale | Standard Error 42.26 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Pain QOL | 63.43 scores on a scale | Standard Error 42.26 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | General health perceptions | 69.14 scores on a scale | Standard Error 20.44 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Energy/Fatigue QOL | 58.30 scores on a scale | Standard Error 16.79 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Social Functioning QOL | 80.19 scores on a scale | Standard Error 23.03 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Emotional health problems QOL | 67.28 scores on a scale | Standard Error 43.19 |
| Serial Care Patients | Caregiver Survey Scores at 3 Months, MD vs SC | Overall quality of health care | 3.55 scores on a scale | Standard Error 0.67 |
Primary
Caregiver Survey Scores at 6 Months, MD vs SC
Scores from caregiver surveys that measure quality of life and satisfaction with care received at the time the 6-month survey was taken. (cont) Physical Functioning QOL - 10 items; Physical Health Problems QOL - 4 items; Pain QOL - 2 items; General health perceptions - 5 items; Energy/fatigue QOL - 4 items; Social Functioning QOL - 2 items; Emotional health problems QOL - 3 items; Emotional well-being QOL - 5 items. All health related quality of life measures are from the SF-36 survey tool, and use a range of 0-100 mean score (higher is better).
Time frame: Within 30 days of 6 months after baseline survey administration
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Overall quality of health care | 3.24 scores on a scale | Standard Error 0.87 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Radiation | 1.05 scores on a scale | Standard Error 0.83 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Chemo | 1.03 scores on a scale | Standard Error 0.68 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Satisfaction with nurse communication | 22.88 scores on a scale | Standard Error 3.5 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Depression | 2.97 scores on a scale | Standard Error 2.89 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Surgery | 1.05 scores on a scale | Standard Error 0.67 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Family role | 0.78 scores on a scale | Standard Error 0.49 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Satisfaction with treatment plan | 1.79 scores on a scale | Standard Error 0.48 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Satisfaction patient can complete treatment plan | 1.78 scores on a scale | Standard Error 0.58 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Satisfaction with quality of care | 16.33 scores on a scale | Standard Error 2.2 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Satisfaction with physician communication | 19.27 scores on a scale | Standard Error 2.41 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Overall team satisfaction | 11.27 scores on a scale | Standard Error 1.42 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Anxiety | 5.42 scores on a scale | Standard Error 3.67 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Physical Functioning QOL | 75.15 scores on a scale | Standard Error 28.84 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Physical health problems QOL | 73.48 scores on a scale | Standard Error 41.43 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Pain QOL | 81.44 scores on a scale | Standard Error 25.41 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | General health perceptions | 74.09 scores on a scale | Standard Error 17.3 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Energy/Fatigue QOL | 59.75 scores on a scale | Standard Error 22.51 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Social Functioning QOL | 76.59 scores on a scale | Standard Error 24.15 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Emotional health problems QOL | 72.73 scores on a scale | Standard Error 40.36 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Emotional well-being QOL | 67.60 scores on a scale | Standard Error 18.43 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Social Functioning QOL | 80.91 scores on a scale | Standard Error 24.96 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Surgery | 0.91 scores on a scale | Standard Error 0.7 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Overall team satisfaction | 11.73 scores on a scale | Standard Error 0.77 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Depression | 3.45 scores on a scale | Standard Error 2.91 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Chemo | 1.00 scores on a scale | Standard Error 0.71 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | General health perceptions | 62.95 scores on a scale | Standard Error 21.31 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Satisfaction with nurse communication | 23.36 scores on a scale | Standard Error 1.71 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Anxiety | 5.23 scores on a scale | Standard Error 3.01 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Overall quality of health care | 3.23 scores on a scale | Standard Error 0.92 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Emotional well-being QOL | 63.33 scores on a scale | Standard Error 18.31 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Radiation | 0.88 scores on a scale | Standard Error 0.7 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Physical Functioning QOL | 79.67 scores on a scale | Standard Error 25.1 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Family role | 0.76 scores on a scale | Standard Error 0.54 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Energy/Fatigue QOL | 54.85 scores on a scale | Standard Error 15.39 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Satisfaction with treatment plan | 1.86 scores on a scale | Standard Error 0.35 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Physical health problems QOL | 69.32 scores on a scale | Standard Error 46.25 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Satisfaction patient can complete treatment plan | 1.72 scores on a scale | Standard Error 0.57 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Emotional health problems QOL | 74.24 scores on a scale | Standard Error 42.33 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Satisfaction with quality of care | 14.14 scores on a scale | Standard Error 2.96 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Pain QOL | 84.66 scores on a scale | Standard Error 28.85 |
| Serial Care Patients | Caregiver Survey Scores at 6 Months, MD vs SC | Satisfaction with physician communication | 19.50 scores on a scale | Standard Error 1.44 |
Primary
Caregiver Survey Scores at Baseline, MD vs SC
Scores from caregiver surveys that measure quality of life and satisfaction with care received at the time the baseline survey was taken. Overall quality of health care - satisfaction with overall quality of health care since lung cancer diagnosis; range:0-4 (higher is better) Treatment decision-making: Surgery/Radiation/Chemotherapy - each 1 item; satisfaction with treatment decision-making; range: 0-2 (0=patient controlled; 1=shared decision; 2-physician decision; closer to 1 is best) Treatment decision-making: family role - satisfaction with family role in treatment decision-making; range: 0-2 (0=patient controlled; 1=shared decision; 2-physician decision; closer to 1 is best) Satisfaction with treatment plan - satisfaction with overall treatment plan; range: 0-2 (higher is better) Satisfaction patient can complete treatment plan; range: 0-2 (higher is better) (continued in 3 month survey description)
Time frame: Baseline
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Satisfaction with quality of care | 16.41 scores on a scale | Standard Error 2.57 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Treatment decision-making: Surgery | 0.78 scores on a scale | Standard Error 0.65 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Treatment decision-making: Radiation | 0.94 scores on a scale | Standard Error 0.69 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Overall team satisfaction | 10.66 scores on a scale | Standard Error 2.29 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Satisfaction with physician communication | 18.95 scores on a scale | Standard Error 2.48 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Anxiety | 6.57 scores on a scale | Standard Error 4.45 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Treatment decision-making: Chemo | 0.88 scores on a scale | Standard Error 0.59 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Physical Functioning QOL | 78.23 scores on a scale | Standard Error 27.38 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Physical health problems QOL | 74.49 scores on a scale | Standard Error 38.46 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Depression | 3.12 scores on a scale | Standard Error 3.49 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Pain QOL | 81.89 scores on a scale | Standard Error 26.14 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Treatment decision-making: Family role | 0.68 scores on a scale | Standard Error 0.5 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | General health perceptions | 72.13 scores on a scale | Standard Error 19.63 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Overall quality of health care | 3.27 scores on a scale | Standard Error 0.98 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Energy/Fatigue QOL | 57.66 scores on a scale | Standard Error 21.02 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Satisfaction with treatment plan | 1.40 scores on a scale | Standard Error 0.83 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Social Functioning QOL | 78.98 scores on a scale | Standard Error 26.6 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Satisfaction with nurse communication | 21.96 scores on a scale | Standard Error 4.29 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Emotional health problems QOL | 74.75 scores on a scale | Standard Error 40.15 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Emotional well-being QOL | 65.09 scores on a scale | Standard Error 22.96 |
| Multidisciplinary Clinic Patients | Caregiver Survey Scores at Baseline, MD vs SC | Satisfaction patient can complete treatment plan | 1.44 scores on a scale | Standard Error 0.8 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Emotional well-being QOL | 68.33 scores on a scale | Standard Error 19.17 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Satisfaction patient can complete treatment plan | 1.63 scores on a scale | Standard Error 0.68 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Satisfaction with nurse communication | 22.46 scores on a scale | Standard Error 3.68 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Depression | 3.76 scores on a scale | Standard Error 3.45 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Physical Functioning QOL | 77.24 scores on a scale | Standard Error 25.88 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Emotional health problems QOL | 72.77 scores on a scale | Standard Error 40.61 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Overall quality of health care | 3.14 scores on a scale | Standard Error 0.95 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Treatment decision-making: Radiation | 1.03 scores on a scale | Standard Error 0.67 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Treatment decision-making: Chemo | 0.98 scores on a scale | Standard Error 0.63 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Treatment decision-making: Family role | 0.73 scores on a scale | Standard Error 0.52 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Satisfaction with treatment plan | 1.61 scores on a scale | Standard Error 0.66 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Satisfaction with quality of care | 13.90 scores on a scale | Standard Error 2.94 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Satisfaction with physician communication | 18.76 scores on a scale | Standard Error 2.52 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Overall team satisfaction | 10.57 scores on a scale | Standard Error 2.29 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Anxiety | 6.90 scores on a scale | Standard Error 4.77 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Physical health problems QOL | 68.71 scores on a scale | Standard Error 42.04 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Pain QOL | 80.32 scores on a scale | Standard Error 28.98 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | General health perceptions | 69.35 scores on a scale | Standard Error 21.04 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Energy/Fatigue QOL | 59.04 scores on a scale | Standard Error 20.62 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Social Functioning QOL | 76.97 scores on a scale | Standard Error 24.83 |
| Serial Care Patients | Caregiver Survey Scores at Baseline, MD vs SC | Treatment decision-making: Surgery | 0.90 scores on a scale | Standard Error 0.71 |
Primary
Clinical Provider Survey Responses - Ease of Referring Patients to the Conference
Responses from clinical providers will measure provider satisfaction and obstacles to institutional multidisciplinary care.
Time frame: After a provider referred their 5th patient to the multidisciplinary conference (baseline), then within 30 days of 6 months and 12 months, respectively, after baseline survey was completed
Population: Any clinical provider who referred at least 5 patients to the multidisciplinary program and consented to take satisfaction surveys.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Very Satisfied | 9 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Very Dissatisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Satisfied | 2 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Somewhat satisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Somewhat dissatisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Somewhat dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Very Satisfied | 7 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Somewhat satisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Very Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Satisfied | 1 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Very Dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Satisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Somewhat satisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Somewhat dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - Ease of Referring Patients to the Conference | Very Satisfied | 5 Participants |
Primary
Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient
Responses from clinical providers will measure provider satisfaction and obstacles to institutional multidisciplinary care.
Time frame: After a provider referred their 5th patient to the multidisciplinary conference (baseline), then within 30 days of 6 months and 12 months, respectively, after baseline survey was completed
Population: Any clinical provider who referred at least 5 patients to the multidisciplinary program and consented to take satisfaction surveys.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Very Satisfied | 10 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Dissatisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Somewhat satisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Very Dissatisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Satisfied | 1 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Somewhat satisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Very Satisfied | 7 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Satisfied | 1 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Very Dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Very Dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Very Satisfied | 5 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Somewhat satisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - How Quickly I Receive Feedback on my Patient | Satisfied | 0 Participants |
Primary
Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference
Responses from clinical providers will measure provider satisfaction and obstacles to institutional multidisciplinary care.
Time frame: After a provider referred their 5th patient to the multidisciplinary conference (baseline), then within 30 days of 6 months and 12 months, respectively, after baseline survey was completed
Population: Any clinical provider who referred at least 5 patients to the multidisciplinary program and consented to take satisfaction surveys.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Somewhat satisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Satisfied | 1 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Dissatisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Very satisfied | 10 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Very Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Satisfied | 1 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Very satisfied | 7 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Somewhat satisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Very Dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Very Dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Somewhat satisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Satisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - How Quickly my Patients Get Scheduled to be Discussed at the Conference | Very satisfied | 5 Participants |
Primary
Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment
Responses from clinical providers will measure provider satisfaction and obstacles to institutional multidisciplinary care.
Time frame: After a provider referred their 5th patient to the multidisciplinary conference (baseline), then within 30 days of 6 months and 12 months, respectively, after baseline survey was completed
Population: Any clinical provider who referred at least 5 patients to the multidisciplinary program and consented to take satisfaction surveys.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Satisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Dissatisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Somewhat dissatisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Very Satisfied | 10 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | N/A | 1 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Very Dissatisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Somewhat satisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Very Satisfied | 7 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Satisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Somewhat satisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Somewhat dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Very Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | N/A | 1 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Satisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | N/A | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Very Dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Somewhat dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Somewhat satisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Consistency With Which my Patients Are Sent Back for Further Treatment | Very Satisfied | 5 Participants |
Primary
Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients
Responses from clinical providers will measure provider satisfaction and obstacles to institutional multidisciplinary care.
Time frame: After a provider referred their 5th patient to the multidisciplinary conference (baseline), then within 30 days of 6 months and 12 months, respectively, after baseline survey was completed
Population: Any clinical provider who referred at least 5 patients to the multidisciplinary program and consented to take satisfaction surveys.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Very Satisfied | 10 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Satisfied | 1 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Somewhat satisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Somewhat dissatisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Dissatisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Very Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Very Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Very Satisfied | 8 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Somewhat dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Satisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Somewhat satisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Satisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Somewhat satisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Very Dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Somewhat dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Very Satisfied | 5 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Helpfulness of the Staff in Scheduling Patients | Dissatisfied | 0 Participants |
Primary
Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient
Responses from clinical providers will measure provider satisfaction and obstacles to institutional multidisciplinary care.
Time frame: After a provider referred their 5th patient to the multidisciplinary conference (baseline), then within 30 days of 6 months and 12 months, respectively, after baseline survey was completed
Population: Any clinical provider who referred at least 5 patients to the multidisciplinary program and consented to take satisfaction surveys.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Very Satisfied | 10 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Satisfied | 1 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Somewhat satisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Somewhat dissatisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Dissatisfied | 0 Participants |
| Multidisciplinary Clinic Patients | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Very Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Very Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Very Satisfied | 6 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Somewhat dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Dissatisfied | 0 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Satisfied | 2 Participants |
| Serial Care Patients | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Somewhat satisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Satisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Somewhat satisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Very Dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Somewhat dissatisfied | 0 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Very Satisfied | 5 Participants |
| Serial Care Patients Not Presented in Conference | Clinical Provider Survey Responses - The Quality of Treatment Recommendations That I Received for my Patient | Dissatisfied | 0 Participants |
Primary
Concordance Rate for Any Conference Recommendation, MD vs SC (Conference)
Number of patients for whom any initial conference recommendation was completed. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. Note that two patients (one from the MD arm and one from the SC arm) have died before receiving recommendations and therefore were not analyzed for this outcome.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the end of a patient's last line of treatment, an average of 1-2 months
Population: Patients with a conference lung cancer who enrolled in the study who did not die, or leave the study before treatment, or did not refuse treatment.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Concordance Rate for Any Conference Recommendation, MD vs SC (Conference) | No | 3 Participants |
| Multidisciplinary Clinic Patients | Concordance Rate for Any Conference Recommendation, MD vs SC (Conference) | Yes | 174 Participants |
| Serial Care Patients | Concordance Rate for Any Conference Recommendation, MD vs SC (Conference) | No | 4 Participants |
| Serial Care Patients | Concordance Rate for Any Conference Recommendation, MD vs SC (Conference) | Yes | 71 Participants |
p-value: 0.049995% CI: [1.002, 999.999]Regression, Logistic
Primary
Concordance Rate for Initial Conference Recommendations, MD vs SC (Conference)
Number of patients for whom all recommendations made at the initial multidisciplinary conference were completed. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. Note that two patients (one from the MD arm and one from the SC arm) have died before receiving recommendations and therefore were not analyzed for this outcome.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the end of a patient's last line of treatment, an average of 1-2 months
Population: Patients with a conference lung cancer who enrolled in the study who did not die, or leave the study before treatment, or did not refuse treatment.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Concordance Rate for Initial Conference Recommendations, MD vs SC (Conference) | Yes | 140 Participants |
| Multidisciplinary Clinic Patients | Concordance Rate for Initial Conference Recommendations, MD vs SC (Conference) | No | 37 Participants |
| Serial Care Patients | Concordance Rate for Initial Conference Recommendations, MD vs SC (Conference) | Yes | 45 Participants |
| Serial Care Patients | Concordance Rate for Initial Conference Recommendations, MD vs SC (Conference) | No | 30 Participants |
p-value: 0.001495% CI: [1.52, 5.747]Regression, Logistic
Primary
Concordance Rate for Initial Conference Recommendation(s) With Prior Condition Met, MD vs SC (Conference)
Number of patients for whom all initial conference recommendations were completed, excluding conditional recommendations for which the prior condition was not met. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. Note that two patients (one from the MD arm and one from the SC arm) have died before receiving recommendations and therefore were not analyzed for this outcome. E.g., if a recommendation was to have a PET/CT and then a staging biopsy if the PET showed suspicious metastatic disease, the staging biopsy recommendation was excluded from the concordance measure if the PET/CT did not happen or was negative.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the end of a patient's last line of treatment, an average of 1-2 months
Population: Patients with a conference lung cancer who enrolled in the study who did not die, or leave the study before treatment, or did not refuse treatment.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Concordance Rate for Initial Conference Recommendation(s) With Prior Condition Met, MD vs SC (Conference) | No | 32 Participants |
| Multidisciplinary Clinic Patients | Concordance Rate for Initial Conference Recommendation(s) With Prior Condition Met, MD vs SC (Conference) | Yes | 145 Participants |
| Serial Care Patients | Concordance Rate for Initial Conference Recommendation(s) With Prior Condition Met, MD vs SC (Conference) | Yes | 49 Participants |
| Serial Care Patients | Concordance Rate for Initial Conference Recommendation(s) With Prior Condition Met, MD vs SC (Conference) | No | 26 Participants |
p-value: 0.001995% CI: [1.519, 6.299]Regression, Logistic
Primary
Concordance Rate for Treatment Recommendations With Prior Recommendations Completed, MD vs SC (Conference)
Number of patients for whom the treatment recommendation made at the initial conference presentation was completed, excluding any patient for whom prior recommendations (staging, diagnosis, surveillance) were not also completed. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the end of a patient's last line of treatment, an average of 1-2 months
Population: Patients with a conference lung cancer who enrolled in the study who did not die, or leave the study before treatment, or did not refuse treatment excluding any patient for whom prior recommendations (staging, diagnosis, surveillance) were not also completed.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Concordance Rate for Treatment Recommendations With Prior Recommendations Completed, MD vs SC (Conference) | Yes | 87 Participants |
| Multidisciplinary Clinic Patients | Concordance Rate for Treatment Recommendations With Prior Recommendations Completed, MD vs SC (Conference) | No | 14 Participants |
| Serial Care Patients | Concordance Rate for Treatment Recommendations With Prior Recommendations Completed, MD vs SC (Conference) | Yes | 38 Participants |
| Serial Care Patients | Concordance Rate for Treatment Recommendations With Prior Recommendations Completed, MD vs SC (Conference) | No | 8 Participants |
p-value: 0.150395% CI: [0.711, 9.269]Regression, Logistic
Primary
Overall Concordance Rate Using a Hierarchy of Initial Conference Recommendations, MD vs SC (Conference)
Number of patients for whom the overall initial conference recommendation was completed. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. Note that two patients (one from the MD arm and one from the SC arm) have died before receiving recommendations and therefore were not analyzed for this outcome. The hierarchy to rank recommendations, from highest priority to lowest, was (1) treatment, (2) staging, (3) diagnosis, (4) surveillance. If a patient had a treatment recommendation and it happened, he/she was concordant. If treatment was recommended and it did not happen, he/she was discordant. If no treatment recommendation was made, then concordance was measured by whether or not the staging recommendation was met. If no staging recommendation was made, then the diagnostic recommendation was given priority for a concordance measurement. If no diagnostic recommendation, then a surveillance recommendation was used to measure overall concordance.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the end of a patient's last line of treatment, an average of 1-2 months
Population: Patients with a conference lung cancer who enrolled in the study who did not die, or leave the study before treatment, or did not refuse treatment.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Overall Concordance Rate Using a Hierarchy of Initial Conference Recommendations, MD vs SC (Conference) | Yes | 158 Participants |
| Multidisciplinary Clinic Patients | Overall Concordance Rate Using a Hierarchy of Initial Conference Recommendations, MD vs SC (Conference) | No | 19 Participants |
| Serial Care Patients | Overall Concordance Rate Using a Hierarchy of Initial Conference Recommendations, MD vs SC (Conference) | Yes | 60 Participants |
| Serial Care Patients | Overall Concordance Rate Using a Hierarchy of Initial Conference Recommendations, MD vs SC (Conference) | No | 15 Participants |
p-value: 0.026395% CI: [1.123, 6.319]Regression, Logistic
Primary
Patient Disease/Progression Free Survival
Event-free survival (EFS), as measured from the time from cancer diagnosis to disease progression, death, or data censoring, is analyzed and summarized with the survival probabilities over time using the Kaplan-Meier method. Confidence intervals for the 1- and 3- year survival probabilities are reported. Additionally, the Cox proportional hazard model was used to estimate hazard ratios which are reported in the statistical analyses with 95% confidence intervals.
Time frame: measured from the time from cancer diagnosis to disease progression, death, or data censoring, up to 6 years
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Patient Disease/Progression Free Survival | 1-year EFS survival estimate | 0.45 survival probability |
| Multidisciplinary Clinic Patients | Patient Disease/Progression Free Survival | 3-year EFS survival estimate | 0.26 survival probability |
| Serial Care Patients | Patient Disease/Progression Free Survival | 3-year EFS survival estimate | 0.26 survival probability |
| Serial Care Patients | Patient Disease/Progression Free Survival | 1-year EFS survival estimate | 0.48 survival probability |
p-value: 0.9874Log Rank
p-value: 0.895% CI: [0.82, 1.29]Regression, Cox
Primary
Patient Disease/Progression Free Survival With SC Further Broken Down
Event-free survival (EFS), as measured from the time from cancer diagnosis to disease progression, death, or data censoring, is analyzed and summarized with the survival probabilities over time using the Kaplan-Meier method. Confidence intervals for the 1- and 3- year survival probabilities are reported. Additionally, the Cox proportional hazard model was used to estimate hazard ratios which are reported in the statistical analyses with 95% confidence intervals. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model.
Time frame: As measured from the time from cancer diagnosis to death or data censor, up to 6 years
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Patient Disease/Progression Free Survival With SC Further Broken Down | 1-year EFS survival estimate | 0.45 survival probability |
| Multidisciplinary Clinic Patients | Patient Disease/Progression Free Survival With SC Further Broken Down | 3-year EFS survival estimate | 0.26 survival probability |
| Serial Care Patients | Patient Disease/Progression Free Survival With SC Further Broken Down | 1-year EFS survival estimate | 0.55 survival probability |
| Serial Care Patients | Patient Disease/Progression Free Survival With SC Further Broken Down | 3-year EFS survival estimate | 0.32 survival probability |
| Serial Care Patients Not Presented in Conference | Patient Disease/Progression Free Survival With SC Further Broken Down | 1-year EFS survival estimate | 0.46 survival probability |
| Serial Care Patients Not Presented in Conference | Patient Disease/Progression Free Survival With SC Further Broken Down | 3-year EFS survival estimate | 0.24 survival probability |
p-value: 0.5377Log Rank
p-value: 0.7395% CI: [0.83, 1.34]Regression, Cox
p-value: 0.7395% CI: [0.82, 1.57]Regression, Cox
Primary
Patient Overall Survival
Overall survival, defined as the time from cancer diagnosis to death from any cause or data censoring, is analyzed and summarized with the survival probabilities over time using the Kaplan-Meier method. Confidence intervals for the 1- and 3- year survival probabilities are reported. Additionally, the Cox proportional hazard model was used to estimate hazard ratios which are reported in the statistical analyses with 95% confidence intervals.
Time frame: As measured from the time from cancer diagnosis to death or data censor, up to 6 years
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Patient Overall Survival | 1-year overall survival estimate | 0.58 survival probability |
| Multidisciplinary Clinic Patients | Patient Overall Survival | 3-year overall survival estimate | 0.34 survival probability |
| Serial Care Patients | Patient Overall Survival | 1-year overall survival estimate | 0.60 survival probability |
| Serial Care Patients | Patient Overall Survival | 3-year overall survival estimate | 0.36 survival probability |
p-value: 0.7506Log Rank
p-value: 0.5495% CI: [0.85, 1.36]Regression, Cox
Primary
Patient Overall Survival With SC Further Broken Down
Overall survival, defined as the time from cancer diagnosis to death from any cause or data censoring, is analyzed and summarized with the survival probabilities over time using the Kaplan-Meier method. Confidence intervals for the 1- and 3- year survival probabilities are reported. Additionally, the Cox proportional hazard model was used to estimate hazard ratios which are reported in the statistical analyses with 95% confidence intervals. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model.
Time frame: As measured from the time from cancer diagnosis to death or data censor, up to 6 years
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Patient Overall Survival With SC Further Broken Down | 1-year overall survival estimate | 0.58 survival probability |
| Multidisciplinary Clinic Patients | Patient Overall Survival With SC Further Broken Down | 3-year overall survival estimate | 0.34 survival probability |
| Serial Care Patients | Patient Overall Survival With SC Further Broken Down | 1-year overall survival estimate | 0.64 survival probability |
| Serial Care Patients | Patient Overall Survival With SC Further Broken Down | 3-year overall survival estimate | 0.41 survival probability |
| Serial Care Patients Not Presented in Conference | Patient Overall Survival With SC Further Broken Down | 1-year overall survival estimate | 0.58 survival probability |
| Serial Care Patients Not Presented in Conference | Patient Overall Survival With SC Further Broken Down | 3-year overall survival estimate | 0.34 survival probability |
p-value: 0.4847Log Rank
p-value: 0.5195% CI: [0.87, 1.43]Regression, Cox
p-value: 0.5195% CI: [0.84, 1.67]Regression, Cox
Primary
Patient Survey Scores at 3 Months, MD vs SC
Scores from patient surveys that measure quality of life and satisfaction with care received at the time the 3-month survey was taken. (continued from baseline) Satisfaction with quality of care - overall satisfaction with care received from all care team members; range: 0-18 (sum of 6 items, higher is better) Satisfaction with physician communication - overall satisfaction with physician communication; range: 0-21 (sum of 7 items, higher is better) Satisfaction with nurse communication - overall satisfaction with nurse communication; range: 0-18 (sum of 6 items, higher is better) Overall team satisfaction - CAHPS satisfaction with care from team as a whole; range: 0-15 (sum of 4 items, higher is better) Physical/Social/Functional well-being - health-related quality of life relating to physical/social/functional well-being; range 0-28 (each a sum of 7 items, higher is better) (description continues in 6 month survey description)
Time frame: Within 30 days of 3 months after baseline survey administration
Population: Patients who completed 3-month surveys.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Anxiety | 4.79 scores on a scale | Standard Error 4.02 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Overall quality of health care | 3.31 scores on a scale | Standard Error 0.89 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Surgery | 0.93 scores on a scale | Standard Error 0.61 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Radiation | 1.07 scores on a scale | Standard Error 0.55 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Family role | 0.72 scores on a scale | Standard Error 0.5 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Satisfaction with treatment plan | 4.60 scores on a scale | Standard Error 0.82 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Financial burden of care | 5.25 scores on a scale | Standard Error 1.16 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Satisfaction with quality of care | 16.09 scores on a scale | Standard Error 2.36 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Overall team satisfaction | 13.94 scores on a scale | Standard Error 2.04 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Functional well-being | 22.57 scores on a scale | Standard Error 7.17 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Physical well-being | 25.62 scores on a scale | Standard Error 7 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Social well-being | 18.42 scores on a scale | Standard Error 3.85 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Satisfaction with physician communication | 19.03 scores on a scale | Standard Error 2.34 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Lung cancer specific QOL | 33.31 scores on a scale | Standard Error 5.89 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Total Summary Score FACTL | 124.89 scores on a scale | Standard Error 22.12 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Emotional well-being | 24.69 scores on a scale | Standard Error 5.5 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Generic score FACTG | 91.67 scores on a scale | Standard Error 18.33 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Chemotherapy | 0.97 scores on a scale | Standard Error 0.58 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Trial outcome index | 81.39 scores on a scale | Standard Error 17.03 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Satisfaction with nurse communication | 17.17 scores on a scale | Standard Error 2.54 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 3 Months, MD vs SC | Depression | 5.37 scores on a scale | Standard Error 4.15 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Anxiety | 4.50 scores on a scale | Standard Error 4.01 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Financial burden of care | 5.11 scores on a scale | Standard Error 1.19 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Radiation | 1.13 scores on a scale | Standard Error 0.66 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Satisfaction with treatment plan | 4.59 scores on a scale | Standard Error 0.84 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Satisfaction with quality of care | 14.33 scores on a scale | Standard Error 2.3 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Satisfaction with physician communication | 19.01 scores on a scale | Standard Error 2.1 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Satisfaction with nurse communication | 17.33 scores on a scale | Standard Error 1.73 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Physical well-being | 26.25 scores on a scale | Standard Error 7.08 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Social well-being | 18.92 scores on a scale | Standard Error 3.25 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Functional well-being | 23.16 scores on a scale | Standard Error 6.55 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Lung cancer specific QOL | 33.36 scores on a scale | Standard Error 5.06 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Trial outcome index | 82.77 scores on a scale | Standard Error 15.14 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Surgery | 1.17 scores on a scale | Standard Error 0.64 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Chemotherapy | 1.05 scores on a scale | Standard Error 0.53 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Treatment decision-making: Family role | 0.74 scores on a scale | Standard Error 0.47 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Overall team satisfaction | 13.69 scores on a scale | Standard Error 2.31 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Emotional well-being | 24.85 scores on a scale | Standard Error 5.09 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Total Summary Score FACTL | 126.59 scores on a scale | Standard Error 19.6 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Generic score FACTG | 93.16 scores on a scale | Standard Error 16.53 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Depression | 4.81 scores on a scale | Standard Error 3.96 |
| Serial Care Patients | Patient Survey Scores at 3 Months, MD vs SC | Overall quality of health care | 3.30 scores on a scale | Standard Error 0.82 |
Primary
Patient Survey Scores at 6 Months, MD vs SC
Scores from patient surveys that measure quality of life and satisfaction with care received at the time the 6-month survey was taken. (cont) Emotional well-being - health-related quality of life related to emotional well-being; range 0-30 (sum of 6 items, higher is better) Lung cancer specific QOL - health-related quality of life related to lung cancer diagnosis; range: 0-36 (sum of 9 items, higher is better) Total Summary Score FACTL - full survey, functional assessment of cancer therapy - lung; range: 0-136 (sum of 36 items, higher is better) Generic Score FACTG - full survey, functional assessment of cancer therapy - general; range: 0-108 (sum of 27 items, higher is better) Trial Outcome Index - health related quality of life - trial outcome index; range: 0-84 (sum of 23 items, higher is better) Depression/Anxiety - depression/anxiety measured by Hospital Anxiety and Depression Scale; range: 0-21 (sum of 7 items each, higher is worse)
Time frame: Within 30 days of 6 months after baseline survey administration
Population: Patients who completed 6-month surveys.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Lung cancer specific QOL | 34.49 scores on a scale | Standard Error 5.96 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Satisfaction with physician communication | 19.33 scores on a scale | Standard Error 1.5 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Physical well-being | 28.46 scores on a scale | Standard Error 5.59 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Functional well-being | 24.22 scores on a scale | Standard Error 6.07 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Emotional well-being | 26.15 scores on a scale | Standard Error 4.63 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Financial burden of care | 5.48 scores on a scale | Standard Error 0.99 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Total Summary Score FACTL | 132.00 scores on a scale | Standard Error 18.26 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Generic score FACTG | 97.61 scores on a scale | Standard Error 14.19 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Depression | 4.07 scores on a scale | Standard Error 3.31 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Overall quality of health care | 3.36 scores on a scale | Standard Error 0.74 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Surgery | 1.15 scores on a scale | Standard Error 0.55 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Radiation | 1.09 scores on a scale | Standard Error 0.62 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Satisfaction with treatment plan | 4.89 scores on a scale | Standard Error 0.46 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Chemo | 1.15 scores on a scale | Standard Error 0.55 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Family role | 0.83 scores on a scale | Standard Error 0.42 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Satisfaction with quality of care | 15.89 scores on a scale | Standard Error 2.21 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Satisfaction with nurse communication | 17.32 scores on a scale | Standard Error 1.88 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Overall team satisfaction | 14.19 scores on a scale | Standard Error 1.59 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Social well-being | 18.62 scores on a scale | Standard Error 3.78 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Trial outcome index | 86.92 scores on a scale | Standard Error 14.39 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at 6 Months, MD vs SC | Anxiety | 3.99 scores on a scale | Standard Error 3.99 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Surgery | 1.09 scores on a scale | Standard Error 0.58 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Financial burden of care | 5.06 scores on a scale | Standard Error 1.3 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Satisfaction with quality of care | 14.41 scores on a scale | Standard Error 2.55 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Functional well-being | 23.41 scores on a scale | Standard Error 6.54 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Overall team satisfaction | 13.73 scores on a scale | Standard Error 2.17 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Radiation | 1.05 scores on a scale | Standard Error 0.67 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Social well-being | 18.29 scores on a scale | Standard Error 3.8 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Satisfaction with nurse communication | 17.04 scores on a scale | Standard Error 2.27 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Satisfaction with treatment plan | 4.58 scores on a scale | Standard Error 0.99 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Emotional well-being | 25.26 scores on a scale | Standard Error 4.72 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Total Summary Score FACTL | 128.00 scores on a scale | Standard Error 19.92 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Lung cancer specific QOL | 33.59 scores on a scale | Standard Error 5.74 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Family role | 0.75 scores on a scale | Standard Error 0.54 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Treatment decision-making: Chemo | 1.06 scores on a scale | Standard Error 0.61 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Generic score FACTG | 94.26 scores on a scale | Standard Error 15.89 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Trial outcome index | 83.96 scores on a scale | Standard Error 15.56 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Physical well-being | 26.94 scores on a scale | Standard Error 6.39 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Depression | 4.81 scores on a scale | Standard Error 4.03 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Anxiety | 4.65 scores on a scale | Standard Error 3.72 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Overall quality of health care | 3.15 scores on a scale | Standard Error 0.87 |
| Serial Care Patients | Patient Survey Scores at 6 Months, MD vs SC | Satisfaction with physician communication | 19.08 scores on a scale | Standard Error 1.85 |
Primary
Patient Survey Scores at Baseline, MD vs SC
Scores from patient surveys that measure quality of life and satisfaction with care received at the time the baseline survey was taken. Overall quality of health care - satisfaction with overall quality of health care since lung cancer diagnosis; range: 0-4 (higher is better) Financial burden of care - assessment of financial burden of care; range: 3-6 (sum of 3 items, higher is worse) Treatment decision-making: Surgery/Radiation/Chemotherapy - each 1 item; satisfaction with treatment decision-making; range: 0-2 (0=patient controlled; 1=shared decision; 2-physician decision; closer to 1 is best) Satisfaction with treatment plan - satisfaction with overall treatment plan; range: 1-5 (sum of 2 items, higher is better) Treatment decision-making: family role - satisfaction with family role in treatment decision-making; range: 0-2 (0=patient controlled; 1=shared decision; 2-physician decision; closer to 1 is best) (descriptions continued in 3 month survey description)
Time frame: Baseline
Population: Patients who completed baseline surveys.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Overall quality of health care | 3.28 scores on a scale | Standard Error 0.99 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Financial burden of care | 5.32 scores on a scale | Standard Error 1.07 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Treatment decision-making: Surgery | 0.92 scores on a scale | Standard Error 0.6 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Treatment decision-making: Chemotherapy | 1.03 scores on a scale | Standard Error 0.66 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Satisfaction with treatment plan | 3.95 scores on a scale | Standard Error 1.54 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Treatment decision-making: Family role | 0.73 scores on a scale | Standard Error 0.56 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Satisfaction with nurse communication | 16.55 scores on a scale | Standard Error 2.75 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Overall team satisfaction | 11.69 scores on a scale | Standard Error 3.41 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Emotional well-being | 24.23 scores on a scale | Standard Error 6.04 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Trial outcome index | 78.70 scores on a scale | Standard Error 16.19 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Treatment decision-making: Radiation | 0.97 scores on a scale | Standard Error 0.64 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Satisfaction with quality of care | 16.05 scores on a scale | Standard Error 2.56 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Satisfaction with physician communication | 18.42 scores on a scale | Standard Error 2.86 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Physical well-being | 24.90 scores on a scale | Standard Error 7.61 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Social well-being | 17.73 scores on a scale | Standard Error 5.23 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Functional well-being | 22.14 scores on a scale | Standard Error 7.33 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Lung cancer specific QOL | 31.87 scores on a scale | Standard Error 5.52 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Total Summary Score FACTL | 121.00 scores on a scale | Standard Error 21.42 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Generic score FACTG | 89.16 scores on a scale | Standard Error 18.17 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Depression | 4.44 scores on a scale | Standard Error 3.91 |
| Multidisciplinary Clinic Patients | Patient Survey Scores at Baseline, MD vs SC | Anxiety | 4.53 scores on a scale | Standard Error 4.08 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Trial outcome index | 79.17 scores on a scale | Standard Error 15.61 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Treatment decision-making: Radiation | 1.10 scores on a scale | Standard Error 0.6 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Financial burden of care | 5.23 scores on a scale | Standard Error 1.12 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Lung cancer specific QOL | 32.25 scores on a scale | Standard Error 5.8 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Satisfaction with quality of care | 13.58 scores on a scale | Standard Error 3.19 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Treatment decision-making: Chemotherapy | 1.01 scores on a scale | Standard Error 0.63 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Anxiety | 5.03 scores on a scale | Standard Error 4.29 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Satisfaction with treatment plan | 4.31 scores on a scale | Standard Error 1.2 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Satisfaction with physician communication | 18.49 scores on a scale | Standard Error 2.85 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Treatment decision-making: Family role | 0.69 scores on a scale | Standard Error 0.53 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Total Summary Score FACTL | 121.71 scores on a scale | Standard Error 21.1 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Satisfaction with nurse communication | 16.71 scores on a scale | Standard Error 2.81 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Depression | 4.92 scores on a scale | Standard Error 4.08 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Overall team satisfaction | 12.24 scores on a scale | Standard Error 3.39 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Physical well-being | 24.88 scores on a scale | Standard Error 6.99 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Social well-being | 18.32 scores on a scale | Standard Error 3.89 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Generic score FACTG | 89.40 scores on a scale | Standard Error 17.73 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Emotional well-being | 24.04 scores on a scale | Standard Error 6 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Functional well-being | 22.05 scores on a scale | Standard Error 7.04 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Overall quality of health care | 3.15 scores on a scale | Standard Error 0.98 |
| Serial Care Patients | Patient Survey Scores at Baseline, MD vs SC | Treatment decision-making: Surgery | 1.14 scores on a scale | Standard Error 0.66 |
Primary
Stage-Appropriateness Treatment Selection, MD vs SC
Number of patients for whom appropriate treatment was given, as determined by the patients' clinical stage and treatment guidelines stipulated by the National Comprehensive Cancer Network (NCCN). 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients. For Stage I or II: surgery (or radiation therapy with documented contraindication to surgery or patient refusal); for Stage III: chemotherapy and radiation therapy with or without surgery; for Stage IV: systemic therapy (or palliative care with documented patient refusal or contraindication to systemic therapy).
Time frame: From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months
Population: Patients with a conference lung cancer who enrolled in the study who did not die, or leave the study before treatment, or did not refuse treatment.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Stage-Appropriateness Treatment Selection, MD vs SC | Yes | 140 Participants |
| Multidisciplinary Clinic Patients | Stage-Appropriateness Treatment Selection, MD vs SC | No | 33 Participants |
| Serial Care Patients | Stage-Appropriateness Treatment Selection, MD vs SC | No | 106 Participants |
| Serial Care Patients | Stage-Appropriateness Treatment Selection, MD vs SC | Yes | 232 Participants |
p-value: 0.004595% CI: [1.24, 3.25]Regression, Logistic
Primary
Stage-Appropriateness Treatment Selection, MD vs SC (Conference) vs SC (no Conference)
Number of patients for whom appropriate treatment was given, as determined by the patients' clinical stage and treatment guidelines stipulated by the National Comprehensive Cancer Network (NCCN). For Stage I or II: surgery (or radiation therapy with documented contraindication to surgery or patient refusal); for Stage III: chemotherapy and radiation therapy with or without surgery; for Stage IV: systemic therapy (or palliative care with documented patient refusal or contraindication to systemic therapy). This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months
Population: Patients with a conference lung cancer who enrolled in the study who did not die, or leave the study before treatment, or did not refuse treatment.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Stage-Appropriateness Treatment Selection, MD vs SC (Conference) vs SC (no Conference) | Yes | 140 Participants |
| Multidisciplinary Clinic Patients | Stage-Appropriateness Treatment Selection, MD vs SC (Conference) vs SC (no Conference) | No | 33 Participants |
| Serial Care Patients | Stage-Appropriateness Treatment Selection, MD vs SC (Conference) vs SC (no Conference) | Yes | 58 Participants |
| Serial Care Patients | Stage-Appropriateness Treatment Selection, MD vs SC (Conference) vs SC (no Conference) | No | 15 Participants |
| Serial Care Patients Not Presented in Conference | Stage-Appropriateness Treatment Selection, MD vs SC (Conference) vs SC (no Conference) | Yes | 174 Participants |
| Serial Care Patients Not Presented in Conference | Stage-Appropriateness Treatment Selection, MD vs SC (Conference) vs SC (no Conference) | No | 91 Participants |
Comparison: We examined treatment selection practices with or without MD care in a single healthcare system.p-value: 0.047495% CI: [1.368, 3.699]Regression, Logistic
p-value: 0.635395% CI: [0.91, 3.37]Regression, Logistic
Primary
Thoroughness of Bi-Modal Staging Practice, MD vs SC
Number of patients receiving two forms of staging tests (bi-modal staging). Bi-modal staging is defined as a CT scan plus any other type of radiologic scan or any biopsy. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months
Population: All Specific Aim 3 patients (patients with histologically confirmed lung cancer (irrespective of histology) and an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) from 0 (asymptomatic) to 2 (symptomatic but out of bed for \>50% of the day)).
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Thoroughness of Bi-Modal Staging Practice, MD vs SC | Yes | 161 Participants |
| Multidisciplinary Clinic Patients | Thoroughness of Bi-Modal Staging Practice, MD vs SC | No | 17 Participants |
| Serial Care Patients | Thoroughness of Bi-Modal Staging Practice, MD vs SC | Yes | 267 Participants |
| Serial Care Patients | Thoroughness of Bi-Modal Staging Practice, MD vs SC | No | 81 Participants |
p-value: 0.000495% CI: [1.67, 5.85]Regression, Logistic
Primary
Thoroughness of Bi-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference)
Number of patients receiving two forms of staging tests (bi-modal staging). Bi-modal staging is defined as a CT scan plus any other type of radiologic scan or any biopsy. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months
Population: All Specific Aim 3 patients (patients with histologically confirmed lung cancer (irrespective of histology) and an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) from 0 (asymptomatic) to 2 (symptomatic but out of bed for \>50% of the day)).
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Thoroughness of Bi-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | Yes | 161 Participants |
| Multidisciplinary Clinic Patients | Thoroughness of Bi-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | No | 17 Participants |
| Serial Care Patients | Thoroughness of Bi-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | Yes | 62 Participants |
| Serial Care Patients | Thoroughness of Bi-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | No | 14 Participants |
| Serial Care Patients Not Presented in Conference | Thoroughness of Bi-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | Yes | 205 Participants |
| Serial Care Patients Not Presented in Conference | Thoroughness of Bi-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | No | 67 Participants |
p-value: 0.00195% CI: [1.671, 6.093]Regression, Logistic
p-value: 0.197295% CI: [0.526, 2.314]Regression, Logistic
Primary
Thoroughness of Invasive Mediastinal Staging, MD vs SC
Number of patients with a test (i.e., biopsy) that provides tissue confirmation of the presence or absence of mediastinal nodal metastasis. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months
Population: All Specific Aim 3 patients (patients with histologically confirmed lung cancer (irrespective of histology) and an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) from 0 (asymptomatic) to 2 (symptomatic but out of bed for \>50% of the day)).
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Thoroughness of Invasive Mediastinal Staging, MD vs SC | Yes | 91 Participants |
| Multidisciplinary Clinic Patients | Thoroughness of Invasive Mediastinal Staging, MD vs SC | No | 87 Participants |
| Serial Care Patients | Thoroughness of Invasive Mediastinal Staging, MD vs SC | Yes | 126 Participants |
| Serial Care Patients | Thoroughness of Invasive Mediastinal Staging, MD vs SC | No | 222 Participants |
p-value: 0.002295% CI: [1.25, 2.8]Regression, Logistic
Primary
Thoroughness of Invasive Mediastinal Staging, MD vs SC (no Conference) vs SC (Conference)
Number of patients with a test (i.e., biopsy) that provides tissue confirmation of the presence or absence mediastinal nodal metastasis. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months
Population: All Specific Aim 3 patients (patients with histologically confirmed lung cancer (irrespective of histology) and an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) from 0 (asymptomatic) to 2 (symptomatic but out of bed for \>50% of the day)).
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Thoroughness of Invasive Mediastinal Staging, MD vs SC (no Conference) vs SC (Conference) | Yes | 91 Participants |
| Multidisciplinary Clinic Patients | Thoroughness of Invasive Mediastinal Staging, MD vs SC (no Conference) vs SC (Conference) | No | 87 Participants |
| Serial Care Patients | Thoroughness of Invasive Mediastinal Staging, MD vs SC (no Conference) vs SC (Conference) | Yes | 40 Participants |
| Serial Care Patients | Thoroughness of Invasive Mediastinal Staging, MD vs SC (no Conference) vs SC (Conference) | No | 36 Participants |
| Serial Care Patients Not Presented in Conference | Thoroughness of Invasive Mediastinal Staging, MD vs SC (no Conference) vs SC (Conference) | No | 186 Participants |
| Serial Care Patients Not Presented in Conference | Thoroughness of Invasive Mediastinal Staging, MD vs SC (no Conference) vs SC (Conference) | Yes | 86 Participants |
p-value: 0.063195% CI: [1.446, 4.444]Regression, Logistic
p-value: 0.070395% CI: [1.536, 3.621]Regression, Logistic
Primary
Thoroughness of Invasive Staging, MD vs SC (Conference) vs SC (no Conference)
Number of patients with a test that provides tissue confirmation of the stage-defining lesion. Tests include a biopsy of any identified suspicious metastatic lesion or the primary lesion in the absence of any other suspicious lesion. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months
Population: All Specific Aim 3 patients (patients with histologically confirmed lung cancer (irrespective of histology) and an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) from 0 (asymptomatic) to 2 (symptomatic but out of bed for \>50% of the day)).
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Thoroughness of Invasive Staging, MD vs SC (Conference) vs SC (no Conference) | Yes | 108 Participants |
| Multidisciplinary Clinic Patients | Thoroughness of Invasive Staging, MD vs SC (Conference) vs SC (no Conference) | No | 70 Participants |
| Serial Care Patients | Thoroughness of Invasive Staging, MD vs SC (Conference) vs SC (no Conference) | Yes | 46 Participants |
| Serial Care Patients | Thoroughness of Invasive Staging, MD vs SC (Conference) vs SC (no Conference) | No | 30 Participants |
| Serial Care Patients Not Presented in Conference | Thoroughness of Invasive Staging, MD vs SC (Conference) vs SC (no Conference) | Yes | 122 Participants |
| Serial Care Patients Not Presented in Conference | Thoroughness of Invasive Staging, MD vs SC (Conference) vs SC (no Conference) | No | 150 Participants |
p-value: 0.036695% CI: [1.665, 3.996]Regression, Logistic
p-value: 0.077995% CI: [1.473, 4.665]Regression, Logistic
Primary
Thoroughness of Invasive Staging, Multidisciplinary (MD) vs Serial Care (SC)
Number of patients with a test that provides tissue confirmation of the stage-defining lesion. Tests include a biopsy of any identified suspicious metastatic lesion or the primary lesion in the absence of any other suspicious lesion. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months
Population: All Specific Aim 3 patients (patients with histologically confirmed lung cancer (irrespective of histology) and an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) from 0 (asymptomatic) to 2 (symptomatic but out of bed for \>50% of the day)).
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Thoroughness of Invasive Staging, Multidisciplinary (MD) vs Serial Care (SC) | Yes | 108 Participants |
| Multidisciplinary Clinic Patients | Thoroughness of Invasive Staging, Multidisciplinary (MD) vs Serial Care (SC) | No | 70 Participants |
| Serial Care Patients | Thoroughness of Invasive Staging, Multidisciplinary (MD) vs Serial Care (SC) | Yes | 168 Participants |
| Serial Care Patients | Thoroughness of Invasive Staging, Multidisciplinary (MD) vs Serial Care (SC) | No | 180 Participants |
p-value: 0.000795% CI: [1.35, 3.06]Regression, Logistic
Primary
Thoroughness of Tri-Modal Staging Practice, MD vs SC
Number of patients receiving three forms of staging tests (tri-modal staging). Tri-modal staging is defined as a CT scan plus any other type of radiologic scan plus any biopsy, or PET/CT plus any biopsy. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months
Population: All Specific Aim 3 patients (patients with histologically confirmed lung cancer (irrespective of histology) and an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) from 0 (asymptomatic) to 2 (symptomatic but out of bed for \>50% of the day)).
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Thoroughness of Tri-Modal Staging Practice, MD vs SC | Yes | 99 Participants |
| Multidisciplinary Clinic Patients | Thoroughness of Tri-Modal Staging Practice, MD vs SC | No | 79 Participants |
| Serial Care Patients | Thoroughness of Tri-Modal Staging Practice, MD vs SC | Yes | 132 Participants |
| Serial Care Patients | Thoroughness of Tri-Modal Staging Practice, MD vs SC | No | 216 Participants |
p-value: <0.000195% CI: [1.5, 3.36]Regression, Logistic
Primary
Thoroughness of Tri-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference)
Number of patients receiving three forms of staging tests (tri-modal staging). Tri-modal staging is defined as a CT scan plus any other type of radiologic scan plus any biopsy, or PET/CT plus any biopsy. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model.
Time frame: From the time of a patient's positive lung cancer diagnosis, to the start of a patient's first-line of treatment, an average of 1-2 months
Population: All Specific Aim 3 patients (patients with histologically confirmed lung cancer (irrespective of histology) and an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) from 0 (asymptomatic) to 2 (symptomatic but out of bed for \>50% of the day)).
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Thoroughness of Tri-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | Yes | 99 Participants |
| Multidisciplinary Clinic Patients | Thoroughness of Tri-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | No | 79 Participants |
| Serial Care Patients | Thoroughness of Tri-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | Yes | 39 Participants |
| Serial Care Patients | Thoroughness of Tri-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | No | 37 Participants |
| Serial Care Patients Not Presented in Conference | Thoroughness of Tri-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | No | 179 Participants |
| Serial Care Patients Not Presented in Conference | Thoroughness of Tri-Modal Staging Practice, MD vs SC (Conference) vs SC (no Conference) | Yes | 93 Participants |
p-value: 0.005595% CI: [1.785, 4.203]Regression, Logistic
p-value: 0.257295% CI: [1.287, 3.905]Regression, Logistic
Primary
Timeliness of Care, MD vs SC
Aggregate time in days from enrollment to a specific care delivery endpoint including: from initial detection of lesion to initial biopsy, from initial detection to non-invasive staging, from initial detection to invasive staging, and from initial detection to definitive treatment. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients.
Time frame: From the time of a patient's initial lesion detection to the designated step in the care process, as noted per row below
Population: Not every patient went to every step, therefore the times only include patients that completed that step.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Timeliness of Care, MD vs SC | From Initial detection of lesion to initial biopsy | 25 Days |
| Multidisciplinary Clinic Patients | Timeliness of Care, MD vs SC | From initial detection to non-invasive staging | 20 Days |
| Multidisciplinary Clinic Patients | Timeliness of Care, MD vs SC | From initial detection to invasive staging | 29 Days |
| Multidisciplinary Clinic Patients | Timeliness of Care, MD vs SC | From initial detection to definitive treatment | 60 Days |
| Serial Care Patients | Timeliness of Care, MD vs SC | From initial detection to definitive treatment | 57 Days |
| Serial Care Patients | Timeliness of Care, MD vs SC | From Initial detection of lesion to initial biopsy | 15 Days |
| Serial Care Patients | Timeliness of Care, MD vs SC | From initial detection to invasive staging | 20 Days |
| Serial Care Patients | Timeliness of Care, MD vs SC | From initial detection to non-invasive staging | 16 Days |
Comparison: Time from Initial Detection of Lesion to Diagnostic Biopsyp-value: 0.0042Wilcoxon (Mann-Whitney)
Comparison: Time from Initial Detection of Lesion to Non-invasive Staging Testp-value: 0.0805Wilcoxon (Mann-Whitney)
Comparison: Time from Initial Detection of Lesion to Invasive Staging Testp-value: 0.0073Wilcoxon (Mann-Whitney)
Comparison: Time from Initial Detection of Lesion to Definitive Treatmentp-value: 0.0579Wilcoxon (Mann-Whitney)
Primary
Timeliness of Care, MD vs SC (Conference) vs SC (no Conference)
Aggregate time in days from enrollment to specific care delivery endpoint including: from initial detection of lesion to initial biopsy, from initial detection to non-invasive staging, from initial detection to invasive staging, and from initial detection to definitive treatment. This measure compares 3 groups, instead of 2, because some patients in the serial care group were presented for discussion in a multidisciplinary thoracic oncology conference while still not being seen in the multidisciplinary clinic setting. Therefore, we split the serial care group in two in order to measure the potential impact of a multidisciplinary conference model, separate from the multidisciplinary clinic model.
Time frame: From the time of a patient's initial lesion detection to the designated step in the care process, as noted per row below
Population: Not every patient went to every step, therefore the times only include patients that completed that step.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Timeliness of Care, MD vs SC (Conference) vs SC (no Conference) | From initial detection to non-invasive staging | 20 Days |
| Multidisciplinary Clinic Patients | Timeliness of Care, MD vs SC (Conference) vs SC (no Conference) | From initial detection to definitive treatment | 60 Days |
| Multidisciplinary Clinic Patients | Timeliness of Care, MD vs SC (Conference) vs SC (no Conference) | From Initial detection of lesion to initial biopsy | 25 Days |
| Multidisciplinary Clinic Patients | Timeliness of Care, MD vs SC (Conference) vs SC (no Conference) | Initial detection of lesion to invasive staging | 29 Days |
| Serial Care Patients | Timeliness of Care, MD vs SC (Conference) vs SC (no Conference) | From initial detection to non-invasive staging | 18 Days |
| Serial Care Patients | Timeliness of Care, MD vs SC (Conference) vs SC (no Conference) | From initial detection to definitive treatment | 69 Days |
| Serial Care Patients | Timeliness of Care, MD vs SC (Conference) vs SC (no Conference) | Initial detection of lesion to invasive staging | 40 Days |
| Serial Care Patients | Timeliness of Care, MD vs SC (Conference) vs SC (no Conference) | From Initial detection of lesion to initial biopsy | 18.5 Days |
| Serial Care Patients Not Presented in Conference | Timeliness of Care, MD vs SC (Conference) vs SC (no Conference) | From initial detection to definitive treatment | 54 Days |
| Serial Care Patients Not Presented in Conference | Timeliness of Care, MD vs SC (Conference) vs SC (no Conference) | From Initial detection of lesion to initial biopsy | 13 Days |
| Serial Care Patients Not Presented in Conference | Timeliness of Care, MD vs SC (Conference) vs SC (no Conference) | From initial detection to non-invasive staging | 16 Days |
| Serial Care Patients Not Presented in Conference | Timeliness of Care, MD vs SC (Conference) vs SC (no Conference) | Initial detection of lesion to invasive staging | 14 Days |
Comparison: Time from Initial Detection of Lesion to Diagnostic Biopsyp-value: 0.0146Kruskal-Wallis
Comparison: Time from Initial Detection of Lesion to Non-invasive Staging Testp-value: 0.16Kruskal-Wallis
Comparison: Time from Initial Detection of Lesion to Invasive Staging Testp-value: 0.0014Kruskal-Wallis
Comparison: Time from Initial Detection of Lesion to Definitive Treatmentp-value: 0.0037Kruskal-Wallis
Primary
Timeliness of Communication, MD vs SC(Conference)
Number of patients for whom formal, verified communication of care management decisions was made to all team members (providers inside and outside the multidisciplinary program, patients and their care-givers) within 48 hours of a care recommendation being made. 2 group comparison between Multidisciplinary Clinic Patients and Serial Care Patients.
Time frame: Within 48 hours of a documented care recommendation made through the multidisciplinary thoracic oncology program
Population: Patients with a conference lung cancer who enrolled in the study who did not die, or leave the study before treatment, or did not refuse treatment.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multidisciplinary Clinic Patients | Timeliness of Communication, MD vs SC(Conference) | Yes | 168 Participants |
| Multidisciplinary Clinic Patients | Timeliness of Communication, MD vs SC(Conference) | No | 10 Participants |
| Serial Care Patients | Timeliness of Communication, MD vs SC(Conference) | No | 2 Participants |
| Serial Care Patients | Timeliness of Communication, MD vs SC(Conference) | Yes | 74 Participants |
| Serial Care Patients Not Presented in Conference | Timeliness of Communication, MD vs SC(Conference) | No | 12 Participants |
| Serial Care Patients Not Presented in Conference | Timeliness of Communication, MD vs SC(Conference) | Yes | 242 Participants |