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Chemotherapy For Lung Cancer: Determinants Of Guideline Adherence And Associated Patient Outcomes, Ramzi George Salloum

Wayne State University Dissertations

Evidence-based guidelines recommend chemotherapy for medically fit patients with stage II-IV non-small cell lung cancer (NSCLC). Adherence to chemotherapy guidelines has rarely been studied among large populations, mainly because performance status (PS), a key component in assessing chemotherapy appropriateness, is missing from claims-based datasets. Among a large cohort of patients with known PS, this dissertation describes chemotherapy use relative to guideline recommendations and identifies patient factors and outcomes associated with guideline concordant use. Among these patients 29% do not receive guideline recommended chemotherapy treatment, missing opportunities for cure or receiving chemotherapy with more risk of harm than benefit, thereby likely …