Winchester

Researchers are evaluating a health services research intervention called the Quality Implementation of Lung Cancer Screening QUILS System, aimed at improving lung cancer screening programs across Kentucky. The study focuses on optimizing statewide lung cancer screening to reduce late-stage lung cancer diagnoses, especially in high-risk areas like Kentuckys Central Appalachian region. This effort is motivated by data showing that lung cancer screening implementation in Kentucky has already contributed to a faster decline in late-stage diagnoses compared to the national average. The intervention involves lung cancer screening program teams receiving the QUILS System, which includes completing the QUILS Index Assessment, participating in QUILS Audit and Feedback presentations, accessing the QUILS Resource Portal, and developing site-specific action plans. Participants also engage in formative evaluation interviews to support the implementation process. This approach is designed to integrate best practices and quality improvement elements into existing screening programs. Participants, who are members or administrators of lung cancer screening programs, will be involved in surveys, audit feedback sessions, and interviews over the course of the study. Researchers will assess changes in the QUILS Index Assessment scores from baseline to month 9 to measure improvements in lung cancer screening quality. The study spans from April 2025 to June 2028, aiming to enhance screening effectiveness and reduce lung cancer burden through program quality improvements.

Researchers are working to improve lung cancer screening programs through an optimization pathway called the QUILS System. This initiative involves assessing current screening programs to identify elements that enhance quality and patient retention. The study focuses on delivering feedback reports to help programs prioritize improvements for better lung cancer screening outcomes. The study uses the QUILS System, which includes statewide coalition engagement through surveys, interviews, educational outreach, and collaborative activities. These efforts aim to raise awareness, improve coordination, support policy, and promote equitable and high-quality lung cancer screening programs. Participants in the study include physicians, nurses, administrators, and other staff involved in lung cancer screening programs. They will engage in the QUILS Index Assessment Survey, receive audit feedback presentations, and participate in formative evaluation interviews. The primary outcome is the change in the QUILS Index Assessment Score one year after the study start. The overall study period extends until June 2028.

Researchers are comparing the rates of surgical and minimally invasive interventions, as well as any harms, in Medicare beneficiaries treated with the MILD procedure versus those treated with interspinous process decompression IPD for lumbar spinal stenosis with neurogenic claudication. This observational study uses Medicare claims data to follow patients for 24 months after their initial procedure starting from January 1, 2017. The purpose is to evaluate outcomes between these two types of procedures without requiring prior patient enrollment or consent. The study includes two groups patients who received MILD, which is a percutaneous image-guided lumbar decompression performed under fluoroscopic guidance through a dorsal approach to the spine, and patients who received IPD, a different device-based decompression procedure. Data on reoperations and complications will be collected for both groups over a 24-month follow-up period using Medicare claims. Enrollment continues until the sponsor decides to stop. Participants involvement is passive as the study uses existing Medicare claims data. Researchers will monitor rates of harms related to the initial procedure and subsequent surgical or minimally invasive interventions over two years. No direct patient visits or interventions are conducted, and the study is exempt from institutional review board oversight. The total study duration extends to December 2026, covering cases treated since early 2017.