Results Summary

What was the research about?

Patients with lung cancer get care from many kinds of doctors. These doctors specialize in different treatments, such as radiation or surgery. Patients often receive one treatment after another. However, their doctors may not talk to each other about the care a patient receives.

In this study, the research team compared health records and survey responses from patients with lung cancer who received treatment in one of three ways:

  • Multidisciplinary care planning. Patients in this group received care in a new clinic that has doctors and nurses with different specialties. All the doctors worked together and with the patients to plan their treatment. A nurse helped arrange the care.
  • Serial care. Patients in this group received usual care for patients with lung cancer. They saw each doctor as needed, without help to coordinate the care.
  • Serial care plus team discussion. Like patients in the serial care group, these patients saw their doctors as needed. But the patient’s main cancer doctor talked about the patient’s care plan at a weekly meeting with other types of doctors. This team of doctors helped decide on a care plan.

The research team wanted to learn if multidisciplinary care planning would help patients with lung cancer live longer or have better quality of life compared with the other two approaches. The team also compared patients’ care with guidelines for how doctors should treat lung cancer.

What were the results?

People lived for about the same length of time in all three approaches.

Compared with patients in the serial care approach, patients in the multidisciplinary care planning and serial care plus team discussion approaches had better quality of care. There was no difference in the quality of care between patients in those two approaches.

Patients and caregivers in the multidisciplinary care planning approach were more satisfied with their care than patients in either serial care approach.

Who was in the study?

The study included 526 patients with lung cancer in the greater Memphis, Tennessee, area. Of these, 68 percent were white, 31 percent were black, and 1 percent were other races. The patients’ average age was 67, and 51 percent were men.

What did the research team do?

Doctors assigned patients to one of three approaches. Patients were in the multidisciplinary care planning approach if their doctors referred them to the new clinic. Those without referrals or who had already started treatment were in the two serial care approaches.

Patients and caregivers completed surveys at the start of the study and three and six months after treatment started. The survey asked patients and their caregivers about satisfaction with the care they received. The research team looked at patients’ health records for up to 18 months after the study started. From the records, they found out what treatments each patient had received and whether they had died.

The research team worked with patients, caregivers, and doctors to create the survey questions and decide what information to collect.

What were the limits of the study?

The research team didn’t assign patients to each approach by chance. The team can’t be sure that the results were due to the multidisciplinary clinic and team discussion or something else.

Future studies could assign patients to approaches by chance. Research might also look at the effect of including patients and caregivers in the team discussion.

How can people use the results?

Lung cancer care clinics can use these results when considering how to improve quality of care and patient satisfaction.

Final Research Report

View this project's final research report.

Journal Citations

Related Journal Citations

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Peer reviewers commented and the researchers made changes or provided responses. Those comments and responses included the following:

  • Reviewers asked for a more thorough description of the process of care in the multidisciplinary care and the serial care models, and more explanation of how patients entered the models. The researchers provided additional details on how referral patterns and provider choice determined which model of care patients received and what types of care patients received under each model.
  • Reviewers commented that the different stages of lung cancer are likely to need different types of care. For instance, stage IV patients were less likely to need surgery or radiation, and many more stage IV patients entered the serial care arm than the multidisciplinary care arm. The researchers agreed that it would be important to use disease stage as subgroups in future analyses of survival but that the data are not yet fully available to complete such analyses.
  • The reviewers noted that the researchers overstated the success of multidisciplinary care in improving the quality and outcomes of lung cancer care. In response, the researchers clarified that multidisciplinary care was measurably linked to patient- and caregiver-reported outcomes but not to clinical outcomes, like survival rates.

Conflict of Interest Disclosures

Project Information

Raymond U. Osarogiagbon, MD
Baptist Memorial Hospital-Tipton
$1,858,125
10.25302/02.2020.IH.13046147
Building a Multidisciplinary Bridge Across the Quality Chasm in Thoracic Oncology

Key Dates

September 2013
August 2018
2013
2018

Study Registration Information

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Last updated: January 20, 2023