Lung cancer is the leading cause of cancer-related mortality in the United States, accounting for 221,200 new cases and 158,040 deaths annually (more than colon, breast and prostate cancers combined). Despite the presence of well-developed guidelines for care, adherence to these recommendations is variable and often poor. To help hospitals achieve optimal adherence to guidelines, meaningful comparative data on adherence to measurable quality indicators in lung cancer care must first be gathered in order to identify areas for improvement. Once such preliminary adherence data are available, assessing specific barriers to evidence- based care will guide the development of interventions to address the barriers. Once the interventions are combined into a quality improvement tool, systematic testing of implementation in a range of hospitals will be needed to assess efficacy, feasibility, sustainability, and generalizability. This project proposes to use a learning collaborative model to assess barriers to guideline adherence in lung cancer care and identify solutions. The ultimate goal of the proposal is to improve guideline adherence and decrease unwanted variation in lung cancer care. Lessons learned through evaluation of hospital adaptation and implementation of interventions will lead to identification of common principles that can guide diverse types of hospitals in providing effective, guideline adherent lung cancer care. This work will lead to a generalizable model to assess cancer care quality, understand the underlying reasons for variability, improve adherence to national guidelines and disseminate evidence-based best practices. The candidate, Dr. Odell, is a board-certified general thoracic surgeon with both a clinical and research focus on the treatment of lung cancer. His clinical training and prior research experience measuring outcomes and assessing interventions to optimize lung cancer treatment and working within the Illinois Surgical Quality Improvement Collaborative (ISQIC) has uniquely prepared him for this proposal. Dr. Odell's career goal is to become an independently funded investigator who combines advanced quantitative and qualitative analytics with expertise in implementation and dissemination science to facilitate effective, evidence-based cancer care though hospital-based programs. To fulfill this goal, he will need specific additional training during this award period to gain expertise in 3 areas: (1) quantitative evaluation methodology, (2) qualitative research methods, and (3) implementation and dissemination science. The mentorship team, experienced collaborators, institutional environment and robust quality improvement infrastructure of ISQIC are ideally suited to these educational goals. Finally, the project serves as an ideal vehicle for my career development objectives and will afford Dr. Odell the opportunity to directly apply the skills and techniques learned in qualitative methods, quantitative improvement principles, and implementation science and will position him to perform ongoing, innovate, independent research in cancer care delivery.

Public Health Relevance

Lung cancer is the leading cause of cancer-related mortality in the United States, yet care frequently diverges from well-established, data-driven guidelines. The proposal will measure variation in evidence-based lung cancer treatment in among hospitals in the existing Illinois Surgical Quality Improvement Collaborative (ISQIC) and then utilize a mixed-methods approach to understand barriers to evidence-based care and guide development and implementation of interventions to improve performance. This work will lead to a generalizable model to assess cancer care quality, understand the underlying reasons for variability, and improve adherence to national guidelines.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Academic/Teacher Award (ATA) (K07)
Project #
Application #
Study Section
Subcommittee I - Transistion to Independence (NCI)
Program Officer
Perkins, Susan N
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Northwestern University at Chicago
Schools of Medicine
United States
Zip Code
Mills, Sara E A; Yeldandi, Anjana V; Odell, David D (2018) Surgical Treatment of Multifocal Pulmonary Mucormycosis. Ann Thorac Surg 106:e93-e95
Engelhardt, Kathryn E; DeCamp, Malcolm M; Yang, Anthony D et al. (2018) Treatment Approaches and Outcomes for Primary Mediastinal Sarcoma: Analysis of 976 Patients. Ann Thorac Surg 106:333-339
Rosenberg, Ari J; Wainwright, Derek A; Rademaker, Alfred et al. (2018) Indoleamine 2,3-dioxygenase 1 and overall survival of patients diagnosed with esophageal cancer. Oncotarget 9:23482-23493
DeLancey, John O; Blay Jr, Eddie; Hewitt, D Brock et al. (2018) The effect of smoking on 30-day outcomes in elective hernia repair. Am J Surg :
Engelhardt, Kathryn E; Odell, David D; DeCamp, Malcolm M (2017) Under-treatment of small cell lung cancer: the case for surgical resection. J Thorac Dis 9:3509-3513