Prediction Models for Lung Cancer Screening
(PASI Trial)

Recruiting in Palo Alto (17 mi)

+3 other locations

Overseen byNichole Tanner, MD

Age: Any Age

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: VA Office of Research and Development

No Placebo Group

Trial Summary

What is the purpose of this trial?Lung cancer is responsible for more deaths in the United States than breast, prostate and colon cancer combined and is the number one cancer killer of Veterans. This is because lung cancer is usually diagnosed when the disease has spread, and cure is less likely. Lung cancer screening (LCS) finds cancer at an earlier stage when it is curable, yet only 20% of eligible Veterans have been screened. Uptake is even lower among Black Veterans despite higher lung cancer risk. Using prediction models to identify high-benefit people for whom LCS should be encouraged improves efficiency and reduces disparities. Moreover, it is more patient-centered as shared decision-making conversations can be tailored with personalized information. The US Preventive Services Task Force has called for research to demonstrate that prediction-augmented LCS can be feasibly implemented at the point-of-care. The investigators propose for VA to lead this effort with a large-scale pragmatic clinical trial to show that prediction-augmented LCS is both feasible and improves LCS uptake.

Eligibility Criteria

This trial is for individuals eligible for lung cancer screening, particularly focusing on Veterans who are at high risk but have low screening rates. It aims to improve early detection in this group, with an emphasis on reducing disparities and increasing uptake among Black Veterans.

Inclusion Criteria

I am 50-80 years old, have a 20 pack-year smoking history, and either currently smoke or quit less than 15 years ago.

Predicted benefit calculated using LYFS-CTVA model exceeds a stringent high-benefit threshold of life-year gains with annual LCS, as recommended in the 2021 CHEST LCS guidelines

Veterans assigned a PCP at a participating site and who meet inclusion criteria at any point during the study timeframe will be enrolled into the trial. There will be two paths to patient inclusion:

Exclusion Criteria

Veterans who have previously undergone lung cancer screening

I am a veteran diagnosed with lung cancer.

Veterans who do not meet the eligibility criteria outlined above

Participant Groups

The study tests whether using prediction models alongside population management tools can increase the efficiency of lung cancer screenings (LCS) and encourage higher participation rates among Veterans.

4Treatment groups

Experimental Treatment

Active Control

Group I: PCP facing tools plus LCS population management dashboardExperimental Treatment2 Interventions

both interventions activated

Group II: PCP facing toolsExperimental Treatment2 Interventions

Suite of PCP facing tools activated

Group III: LCS team population management toolsExperimental Treatment2 Interventions

site-specific dashboard and proactive outreach toolkit

Group IV: Usual CareActive Control1 Intervention

Usual care