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Application of a digital quality measure for cancer diagnosis in Epic Cosmos.

Zimolzak AJ, Khan SP, Singh H, Davila JA. Application of a digital quality measure for cancer diagnosis in Epic Cosmos. Journal of the American Medical Informatics Association : JAMIA. 2024 Oct 11.

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Abstract:

OBJECTIVES: Missed and delayed cancer diagnoses are common, harmful, and often preventable. We previously validated a digital quality measure (dQM) of emergency presentation (EP) of lung cancer in 2 US health systems. This study aimed to apply the dQM to a new national electronic health record (EHR) database and examine demographic associations. MATERIALS AND METHODS: We applied the dQM (emergency encounter followed by new lung cancer diagnosis within 30 days) to Epic Cosmos, a deidentified database covering 184 million US patients. We examined dQM associations with sociodemographic factors. RESULTS: The overall EP rate was 19.6%. EP rate was higher in Black vs White patients (24% vs 19%, P < .001) and patients with younger age, higher social vulnerability, lower-income ZIP code, and self-reported transport difficulties. DISCUSSION: We successfully applied a dQM based on cancer EP to the largest US EHR database. CONCLUSION: This dQM could be a marker for sociodemographic vulnerabilities in cancer diagnosis.




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