Publications by authors named "Vijaya Natchimuthu"
Background: Recent modifications to low-dose CT (LDCT)-based lung cancer screening guidelines increase the number of eligible individuals, particularly among racial and ethnic minorities. Because these populations disproportionately live in metropolitan areas, we analyzed the association between travel time and initial LDCT completion within an integrated, urban safety-net health care system.
Methods: Using Esri's StreetMap Premium, OpenStreetMap, and the r5r package in R, we determined projected private vehicle and public transportation travel times between patient residence and the screening facility for LDCT ordered in March 2017 through December 2022 at Parkland Memorial Hospital in Dallas, Texas.
Article Synopsis
- Low-dose CT-based lung cancer screening (LCS) can reduce mortality in high-risk individuals, but challenges exist, especially for minority and underinsured populations.
- A randomized trial involving 447 participants compared usual care versus telephone-based navigation to improve LCS completion rates.
- Results showed no significant difference in overall completion rates (12% vs 9%), but patients receiving navigation had higher completion rates for subsequent steps (86% vs 79%), highlighting that order placement issues hindered progress.
Low-dose computed tomography-based lung cancer screening represents a complex clinical undertaking that could require multiple referrals, appointments, and time-intensive procedures. These steps may pose difficulties and raise concerns among patients, particularly minority, under-, and uninsured populations. The authors implemented patient navigation to identify and address these challenges.
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- Lung cancer screening trials often involve healthier populations, prompting researchers to study the impact of comorbidities in a real-world group of patients receiving low-dose CT scans for screening.
- The study analyzed 1,358 patients, finding that most had a moderate level of comorbidities, with chronic pulmonary disease being the most prevalent. Overall, 70% completed the LDCT, with no significant link found between comorbidity levels and completion or results.
- The research concluded that while comorbidities were present, they did not affect the likelihood of completing the screening or the outcomes, although the rate of completion improved over time as experience with the process grew.
Background: Less than 5% of eligible individuals in the United States undergo lung cancer screening. Variation in clinicians' participation in lung cancer screening has not been determined.
Patients And Methods: We studied medical providers who ordered ≥ 1 low-dose computed tomography (LDCT) for lung cancer screening from February 2017 through February 2019 in an integrated safety-net healthcare system.
Article Synopsis
- The study investigated lung cancer screening patterns in individuals who were eligible but not enrolled in a screening trial.
- Among the 900 individuals approached, 447 enrolled, revealing no significant demographic differences between the enrolled and nonenrolled groups.
- LDCT completion rates were notably higher for enrolled participants (81%) compared to those who declined (73%) and those who could not be reached (49%), indicating that contact and participation in trials may enhance screening adherence.