Language
English
Publication Date
1-1-2025
Journal
Journal of the American Medical Informatics Association
DOI
10.1093/jamia/ocae253
PMID
39394724
PMCID
PMC11648705
PubMedCentral® Posted Date
10-11-2024
PubMedCentral® Full Text Version
Post-print
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.
Keywords
Humans, Electronic Health Records, Female, Male, Middle Aged, Aged, Lung Neoplasms, United States, Adult, Databases, Factual, Neoplasms, Sociodemographic Factors, Socioeconomic Factors, Emergency Service, Hospital, Quality Indicators, Health Care
Published Open-Access
yes
Recommended Citation
Zimolzak, Andrew J; Khan, Sundas P; Singh, Hardeep; et al., "Application of a Digital Quality Measure for Cancer Diagnosis in Epic Cosmos" (2025). Faculty and Staff Publications. 4530.
https://digitalcommons.library.tmc.edu/baylor_docs/4530