{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T08:27:21Z","timestamp":1780388841660,"version":"3.54.1"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"1","funder":[{"DOI":"10.13039\/100000936","name":"Gordon and Betty Moore Foundation","doi-asserted-by":"publisher","award":["GBMF 8838"],"award-info":[{"award-number":["GBMF 8838"]}],"id":[{"id":"10.13039\/100000936","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000936","name":"Gordon and Betty Moore Foundation","doi-asserted-by":"publisher","award":["GBMF 11505"],"award-info":[{"award-number":["GBMF 11505"]}],"id":[{"id":"10.13039\/100000936","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Houston Veterans Administration"},{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015620","name":"Center for Innovations in Quality, Effectiveness and Safety","doi-asserted-by":"publisher","award":["CIN 13-413"],"award-info":[{"award-number":["CIN 13-413"]}],"id":[{"id":"10.13039\/100015620","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017101","name":"VA National Center for Patient Safety","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017101","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R18HS029347"],"award-info":[{"award-number":["R18HS029347"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01HS028595"],"award-info":[{"award-number":["R01HS028595"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The overall EP rate was 19.6%. EP rate was higher in Black vs White patients (24% vs 19%, P\u2009&amp;lt;\u2009.001) and patients with younger age, higher social vulnerability, lower-income ZIP code, and self-reported transport difficulties.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>We successfully applied a dQM based on cancer EP to the largest US EHR database.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This dQM could be a marker for sociodemographic vulnerabilities in cancer diagnosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocae253","type":"journal-article","created":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T06:21:51Z","timestamp":1728714111000},"page":"227-229","source":"Crossref","is-referenced-by-count":5,"title":["Application of a digital quality measure for cancer diagnosis in Epic Cosmos"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0973-5639","authenticated-orcid":false,"given":"Andrew J","family":"Zimolzak","sequence":"first","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) and Baylor College of Medicine , Houston, TX 77030,","place":["United States"]},{"name":"Department of Medicine, Baylor College of Medicine , Houston, TX 77030,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sundas P","family":"Khan","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) and Baylor College of Medicine , Houston, TX 77030,","place":["United States"]},{"name":"Department of Medicine, Baylor College of Medicine , Houston, TX 77030,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4419-8974","authenticated-orcid":false,"given":"Hardeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) and Baylor College of Medicine , Houston, TX 77030,","place":["United States"]},{"name":"Department of Medicine, Baylor College of Medicine , Houston, TX 77030,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica A","family":"Davila","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) and Baylor College of Medicine , Houston, TX 77030,","place":["United States"]},{"name":"Department of Medicine, Baylor College of Medicine , Houston, TX 77030,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,10,11]]},"reference":[{"key":"2024121616113147000_ocae253-B1","doi-asserted-by":"crossref","first-page":"2543","DOI":"10.1038\/ajg.2009.324","article-title":"Missed opportunities to initiate endoscopic evaluation for colorectal cancer diagnosis","volume":"104","author":"Singh","year":"2009","journal-title":"Am J Gastroenterol"},{"key":"2024121616113147000_ocae253-B2","doi-asserted-by":"crossref","first-page":"3307","DOI":"10.1200\/JCO.2009.25.6636","article-title":"Characteristics and predictors of missed opportunities in lung cancer diagnosis: an electronic health record\u2013based study","volume":"28","author":"Singh","year":"2010","journal-title":"J Clin Oncol"},{"key":"2024121616113147000_ocae253-B3","doi-asserted-by":"crossref","first-page":"S84","DOI":"10.1038\/bjc.2015.47","article-title":"Understanding missed opportunities for more timely diagnosis of cancer in symptomatic patients after presentation","volume":"112","author":"Lyratzopoulos","year":"2015","journal-title":"Br J Cancer"},{"key":"2024121616113147000_ocae253-B4","author":"dQMs\u2014Digital Quality Measures","year":"2023"},{"key":"2024121616113147000_ocae253-B5","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1038\/bjc.2012.408","article-title":"Routes to diagnosis for cancer\u2014determining the patient journey using multiple routine data sets","volume":"107","author":"Elliss-Brookes","year":"2012","journal-title":"Br J Cancer"},{"key":"2024121616113147000_ocae253-B6","doi-asserted-by":"crossref","first-page":"2506","DOI":"10.1200\/JCO.23.01523","article-title":"Development and Implementation of a Digital Quality Measure of Emergency Cancer Diagnosis","volume":"42","author":"Kapadia","year":"2024","journal-title":"J Clin Oncol"},{"key":"2024121616113147000_ocae253-B7","author":"Diaz","year":"2023"},{"key":"2024121616113147000_ocae253-B8","doi-asserted-by":"publisher","DOI":"10.5281\/zenodo.13174660","volume-title":"Analysis Code (Application of a Digital Quality Measure for Cancer Diagnosis in Epic Cosmos)","author":"Zimolzak","year":"2024","edition":"1.02 ed."},{"key":"2024121616113147000_ocae253-B9","doi-asserted-by":"crossref","first-page":"S129","DOI":"10.1038\/bjc.2015.52","article-title":"Cancer-specific variation in emergency presentation by sex, age and deprivation across 27 common and rarer cancers","volume":"112","author":"Abel","year":"2015","journal-title":"Br J Cancer"},{"key":"2024121616113147000_ocae253-B10","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1136\/jech-2017-210371","article-title":"Are inequalities in cancer diagnosis through emergency presentation narrowing, widening or remaining unchanged? Longitudinal analysis of English population-based data 2006-2013","volume":"73","author":"Herbert","year":"2019","journal-title":"J Epidemiol Community Health"},{"key":"2024121616113147000_ocae253-B11","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1038\/s41416-022-01847-x","article-title":"Ethnic inequalities in routes to diagnosis of cancer: a population-based UK cohort study","volume":"127","author":"Martins","year":"2022","journal-title":"Br J Cancer"},{"key":"2024121616113147000_ocae253-B12","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1136\/bmjqs-2014-003675","article-title":"Advancing the science of measurement of diagnostic errors in healthcare: the Safer Dx framework","volume":"24","author":"Singh","year":"2015","journal-title":"BMJ Qual Saf"},{"key":"2024121616113147000_ocae253-B13","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1136\/amiajnl-2014-002747","article-title":"Launching PCORnet, a national patient-centered clinical research network","volume":"21","author":"Fleurence","year":"2014","journal-title":"J Am Med Inform Assoc"},{"key":"2024121616113147000_ocae253-B14","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1056\/NEJMsr1809937","article-title":"The \u201cAll of Us\u201d Research Program","volume":"381","author":"Denny","year":"2019","journal-title":"N Engl J Med"},{"key":"2024121616113147000_ocae253-B15","author":"Optum","year":"2024"},{"key":"2024121616113147000_ocae253-B16","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1007\/s12325-020-01605-6","article-title":"Body mass index variable interpolation to expand the utility of real-world administrative healthcare claims database analyses","volume":"38","author":"Wu","year":"2021","journal-title":"Adv Ther"},{"key":"2024121616113147000_ocae253-B17","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1093\/jamia\/ocaa124","article-title":"Large-scale evidence generation and evaluation across a network of databases (LEGEND): assessing validity using hypertension as a case study","volume":"27","author":"Schuemie","year":"2020","journal-title":"J Am Med Inform Assoc"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/32\/1\/227\/61201955\/ocae253.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/32\/1\/227\/61201955\/ocae253.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T16:11:44Z","timestamp":1734365504000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/32\/1\/227\/7818435"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,11]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,10,11]]},"published-print":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocae253","relation":{},"ISSN":["1067-5027","1527-974X"],"issn-type":[{"value":"1067-5027","type":"print"},{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,1]]},"published":{"date-parts":[[2024,10,11]]}}}