The following is a list of selected publications of PDX-PCCCRT, not our full body of work.

• Rationale and Design of the Lung Cancer Screening Implementation: Evaluation of Patient-Centered Care Study. 2017 Jun.
• This study evaluates communication processes between patients who undergo lung cancer screenings and clinicians. It tests the relationship between quality patient-clinician communication, patient distress, and decisional conflict.

• Identifying Distinct Subgroups of ICU Patients: A Machine Learning Apporach. 2017.
• Tests the effectiveness of a “machine learning approach” to empirically identify subgroups of ICU patients with similar needs and trajectories. The study found that the machine learning approach found important differences between subgroups of ICU patients that are not typically revealed by admitting diagnosis or severity of illness alone.

• Association of decision-making patients’ perceptions of care and knowledge during longitudinal pulmonary nodule surveillance, 2017 May 10.
• Studies the medical decision making roles and perceptions of patients undergoing longitudinal nodule surveillance. A majority of patients prefered active roles in decision making,
  but in some cases did not know what their role was or that a decision was being made.

• Dumping the information bucket: A qualitative study of clinicians caring for patients with early stage non-small cell lung cancer. 2017 May.
• A qualitative study that focuses on clinician experiences communicating with clinical Stage I NSLCLC patients. Clinicians expressed the importance of providing information and mitigating patient worry, but they also reported not clearly eliciting patient preferences and values, a key part of shared decision making.

• Implementation of lung cancer screening: The experience of the Veterans Health Administration. 2017 Feb.
• The aim of this paper is to describe organizational and patient level experiences with implementing a lung cancer screening program at selected Veterans Health Administration hospitals and to estimate the number of VHA patients who may be candidates for LCS. The study estimates that nearly 900,000 of the 6.7 million VHA patients met the criteria for lung cancer screening.

• Longitudinal Changes in Depression Symptoms and Survival Among Patients With Lung Cancer: A National Cohort Assessment, 2016 Nov 20.
• Depression symptoms are common among patients with lung cancer. This study shows that longitudinal changes in depression can have impacts on the survival of lung cancer patients. Depression symptoms especially increased mortality among patients with early-stage lung cancer, but they also increased the mortality of late-stage lung cancer patients in the follow-up part of the study.

• Depression symptom trends and health domains among lung cancer patients in the CanCORS study. 2016 Oct.
• The goal of this study was to identify risk factors for and outcomes of depression among lung cancer patients. Many risk factors and outcomes were identified. Less social support and more lung cancer symptoms increased the association between depression symptoms and increased mortality.

• “Even if I Don’t Remember, I Feel Better”. A Qualitative Study of Patients with Early-Stage Non-Small Cell Lung Cancer Undergoing Stereotactic Body Radiotherapy or Surgery. 2016 Aug.
• This qualitative study describes the experiences of early stage non-small cell lung cancer patients undergoing either surgery or stereotactic body radiotherapy in order to better understand the role that provider-patient communication might play in patient-centered outcomes. It finds that patients felt satisfied with their treatment and their clinicians, but also rarely felt that clinicians explicitly addressed their concerns or worries. This somewhat paradoxical finding and the lack of shared decision-making suggest a need for further research and more effective communication strategies.

• Longitudinal Assessment of Distress among Veterans with Incidental Pulmonary Nodules. 2016.
• Many patients who are diagnosed with pulmonary nodules express increased distress. This study asks if the increased distress is mitigated by participant-reported quality of communication. It finds that most participants experience mild distress at least once. High-quality nodule communication decreased the odds of distress, and low-quality communication of participants’ values and preferences increased odds of distress. These findings suggest that effective communication can indeed lower the distress experienced by patients diagnosed with pulmonary nodules.

• Primary Care Providers and a System Problem: A Qualitative Study of Clinicians Caring for Patients With Incidental Pulmonary Nodules. 2015 Dec.
• Recent increases in lung cancer screening has led to the increased detection and diagnosis of pulmonary nodules. Interviews of clinicians reveal that many primary care providers believe they have inadequate information to counsel patients regarding lung nodules despite a desire for said information. PCPs often lack the systemic resources that would lead to more effective discussions with patients about incidental pulmonary nodules. The researchers conclude that pulmonologists should assist PCPs in providing accurate information to counsel patients and manage conversations about the risk of cancer.

• ‘I still don’t know diddly’: a longitudinal qualitative study of patients’ knowledge and distress while undergoing evaluation of incidental pulmonary nodules. 2015 Apr 2016.
• Active pulmonary nodule surveillance can often take several years, a unique occurrence for cancer regimens. This study evaluates the psychosocial impact on the longitudinal follow-up of incidental nodule detection on patients. Patients expressed continued inadequate knowledge of pulmonary nodules and the nodule follow-up plan. They desired more information about the nodules and lung cancer. Many participants also reported feeling distressed, with varying levels of severity and persistence.

• Distress and patient-centered communication among veterans with incidental (not screen-detected) Pulmonary nodules. A cohort study.
  • The focus of this study is to evaluate the association of communication quality with distress among veterans with incidental pulmonary nodules, with a focus on the frequency and magnitude of said distress. While participant-reported risk of lung cancer was not associated with distress, high-quality communication was associated with decreased distress for these veterans.

• Patient-centered outcomes among lung cancer screening recipients with computed tomography: a systematic review. 2014 Jul.
  • In order to determine the consequences of screening with LDCT and its results on patient-centered outcomes, researchers performed a content analysis of randomized controlled trials involving asymptomatic adults. LDCT lung cancer screening was associated with short-term psychologic discomfort but not distress, worry, or health-related quality of life. In terms of results, false-positives were associated with short-term increases in distress before returning to levels similar to people with negative results.

• What the heck is a “nodule”? A qualitative study of veterans with pulmonary nodules. 2013 Aug.
  • This study explores the experiences patients have with incidentally diagnosed pulmonary nodules. It finds that patients did not understand the term “nodule” but knew it could be related to cancer. Most patients experienced distress, did not understand the nodule follow-up plan, and said they were unable to obtain better information about the nodule.