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. 2025 Jan 1;32(1):227-229.
doi: 10.1093/jamia/ocae253.

Application of a digital quality measure for cancer diagnosis in Epic Cosmos

Andrew J Zimolzak  1   2 , Sundas P Khan  1   2 , Hardeep Singh  1   2 , Jessica A Davila  1   2
Affiliations

Application of a digital quality measure for cancer diagnosis in Epic Cosmos

Andrew J Zimolzak et al. J Am Med Inform Assoc. .

Abstract

Objectives: 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.

Materials and methods: 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.

Results: The overall EP rate was 19.6%. EP rate was higher in Black vs White patients (24% vs 19%, P < .001) and patients with younger age, higher social vulnerability, lower-income ZIP code, and self-reported transport difficulties.

Discussion: We successfully applied a dQM based on cancer EP to the largest US EHR database.

Conclusion: This dQM could be a marker for sociodemographic vulnerabilities in cancer diagnosis.

Keywords: digital quality measure; electronic health record; patient safety; social determinants of health.

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Conflict of interest statement

None declared.

Comment in

References

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