Read Suggested Topics for Research | AHRQ Effective Health Care Program

Topic Suggestion Description

Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.: What is the comparative effectiveness of conventional CT, MDCT (including “virtual CT bronchoscopy”), PET/PET-CT, and MRI for the diagnosis or pretreatment staging of small cell and non-small cell lung cancer?

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.): yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:: As initial suggestions for further assessment: conventional CT, MDCT, PET/CT, & MRI.

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.): Patients with small cell and non-small cell lung cancers of all ages, genders, etc.

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.): A REDUCTION IN LUNG CANCER MORTALITY AND IMPROVEMENT IN QUALITY OF LIFE FOR DIAGNOSED LUNG CANCER PATIENTS.

Describe any health-related risks, side effects, or harms that you are concerned about.: Dangers of suggested imaging modalities include increased exposure to radiation in CT, MDCT, & PET/CT, and the risk of over-diagnosis and unnecessary follow-up testing.

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?: yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

AHRQ Priority Populations

Federal Health Care Program

Describe why this topic is important.: Lung cancer is the leading cause of cancer deaths in the U.S., with an incidence of 60/100,000. Minority groups such as American Indians, and socioeconmically disadvantaged populations are especially at risk due to high rates of smoking, a strong risk factor for lung cancer. MORE EFFECTIVE IMAGING TO DIAGNOSE LUNG CANCER HAS THE POTENTIAL TO FIND TUMORS AT EARLIER STAGES, WHERE THEY ARE MORE TREATABLE. MORE EFFECTIVE STAGING OF THESE CANCERS HAS THE POTENTIAL TO IMPROVE OUTCOMES FOR TREATABLE TUMORS, AND IMPROVE QUALITY OF LIFE FOR UNTREATABLE TUMORS.

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.): THIS TOPIC WAS RECOMMENDED BY A PANEL OF STAKEHOLDERS INVOLVED IN MANY ASPECTS OF CANCER, INCLUDING PATIENT ADVOCACY GROUPS, PROVIDERS, RESEARCHERS, AND MORE. THEY SELECTED IT BASED ON THEIR EVALUATION OF HIGH IMPORTANCE AND VALUE AS A TOPIC FOR A COMPARATIVE EFFECTIVENESS REVIEW.

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.): yes
If yes, please explain:: The best imaging modality for diagnosis and staging is currently controversial among clinicians.

How will an answer to your research question be used or help inform decisions for you or your group?: THE ANSWER TO THIS RESEARCH QUESTION WILL BE USED BY THE EFFECTIVE HEALTH CARE PROGRAM TO INFORM PATIENTS, CLINICIANS, AND POLICY-MAKERS, AMONG OTHER STAKEHOLDERS, OF THE CURRENT STATE OF RESEARCH INTO THIS QUESTION, IN ORDER TO MAKE INFORMED DECISIONS.

Describe the timeframe in which an answer to your question is needed.: AS SOON AS POSSIBLE, TO PROVIDE GUIDANCE TO INVOLVED STAKEHOLDERS.

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.: AS PREVIOUSLY MENTIONED, SOCIOECONOMICALLY DISADVANTAGED AND MINORITY POPUATIONS ARE AT INCREASED RISK DUE TO INCREASED PREVALENCE OF SMOKING IN THESE POPULATIONS.

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

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