Association of Receipt of Positron Emission Tomography–Computed Tomography With Non–Small Cell Lung Cancer Mortality in the Veterans Affairs Health Care System


This supplementary material has been provided by the authors to give readers additional information about their work. eTable 2. Characteristics of Veterans With NSCLC by Utilization of PET-CT Between 2000 and 2013 Variable Never Performed (N=12,259) Any PET/CT (N=51,844) 12 Months Prior (N=25,735) 5 Years After (N=41,242) P-value* Age < 65 
3,694(30.1%) 21,374(41.2%) 10,467(40.7%) 18,013(43.7%) <0.001 




  Rate of Stage-Appropriate Treatment by Year* * P < 0.001 for increase in rate of stage-appropriate treatment by year Utilization of PET/CT by Year and Lung Cancer Stage P < 0.0001 for annual utilization of PET/CT by NSCLC stage. ** Percentages are row percentages (total veterans in a given year and stage who received a PET/CT in each category). 


	45% 50% 55% eTable 1. VA Facility Complexity Level (%) Rate of Stage-Appropriate Treatment by Year Complexity level # VA facilities 1a 39 2007 157 (10.9%) 1281 (89.1%) 662 (46.0%) Definition 2008 139 (9.3%) 1350 (90.7%) 665 (44.7%) 2009 128 (8.4%) 1404 (91.6%) 698 (45.6%) eTable 3. Stage/Ye PET/CT Never Performed Any PET/CT Performed 12 Months Before 2010 70 (6.3%) 1050 (93.8%) 505 (45.1%) 2011 52 (5.1%) 960 (94.9%) 497 (49.1%) ar 2012 57 (5.2%) 1041 (94.8%) 531 (48.4%) • Largest levels of volume, patient risk, teaching and 1061 (73.8%) 1147 (77.0%) 1206 (78.7%) 911 (81.3%) 5 Years After 849(83.9%) 935 (85.2%) 2013 32 (3.6%) 858 (96.4%) 410 (46.1%) 771 (86.6%) All Stages Stage 4 research • Largest number and breadth of physician specialists. 2000 399 (40.8%) 579 (59.2%) 259 (26.5%) 387 (39.6%) 2001 1919 (42.5%) 2594 (57.5%) 1304 (28.9%) 1784 (39.5%) 2002 1730 (38.4%) 2778 (61.6%) 1389 (30.8%) 1968 (43.7%) 2000 210 (50.8%) 203 (49.2%) 93 (22.5%) 120 (29.1%) 2001 1026 (53.5%) 893 (46.5%) 421 (21.9%) 537 (28.0%) 2002 965 (49.7%) 977 (50.3%) 467 (24.0%) 619 (31.9%) Treatment 2003 1602 (35.5%) 2914 (64.5%) 1423 (31.5%) 2091 (46.3%) 2003 891 (45.9%) 1052 (54.1%) 484 (24.9%) 636 (32.7%) • Level 1a facilities contain level 5 Intensive Care 2004 1589 (33.0%) 3226 (67.0%) 1550 (32.2%) 2382 (49.5%) 2004 962 (45.3%) 1163 (54.7%) 540 (25.4%) 733 (34.5%) Unit (ICU) units. 2005 1157 (24.6%) 3541 (75.4%) 1611 (34.3%) 2786 (59.3%) 2005 655 (33.2%) 1318 (66.8%) 564 (28.6%) 910 (46.1%)
	30% 35% 40% 2006 2006 1b 2007 2007 2008 2008 1c 2000 Stage 1 Stage-Appropriate 2009 2009 2010 2010 2011 2011 2012 2012 2013 2013	766 (14.7%) 404 (18.1%) 21 635 (11.7%) 340 (14.7%) 556 (10.1%) 311 (14.1%) 25 59 (27.4%) 542 (9.3%) 301 (13.0%) 415 (8.8%) 267 (13.3%) 349 (7.6%) 245 (12.0%) 334 (6.9%) 219 (10.8%) 266 (6.8%) 190 (11.5%)	4457 (85.3%) 1833 (81.9%) Year 4781 (88.3%) 1974 (85.3%) • Very large levels of volume, patient risk, teaching 2194 (42.0%) 3430 (65.7%) 835 (37.3%) 1245 (55.7%) 2386 (44.1%) 3809 (70.3%) 872 (37.7%) 1408 (60.8%) 4923 (89.9%) 2434 (44.4%) 4055 (74.0%) 1901 (85.9%) 814 (36.8%) 1409 (63.7%) and research • Level 1b facilities contain level 4 and 5 ICU units. • Large levels of volume, patient risk, teaching and 156 (72.6%) 70 (32.6%) 114 (53.0%) • Level 1c facilities contain level 4 ICU units. research 5312 (90.7%) 2605 (44.5%) 2013 (87.0%) 859 (37.1%) 1521 (65.7%) 4432 (75.7%) 4313 (91.2%) 2128 (45.0%) 1743 (86.7%) 763 (38.0%) 1306 (65.0%) 3584 (75.8%) 4240 (92.4%) 2248 (49.0%) 1794 (88.0%) 837 (41.0%) 1364 (66.9%) 3559 (77.6%) 4537 (93.1%) 2370 (48.7%) 1814 (89.2%) 840 (41.3%) 1403 (69.0%) 3853 (79.1%) 3649 (93.2%) 1834 (46.8%) 3122 (79.7%) 1466 (88.5%) 657 (39.7%) 1141 (68.9%)
	2001	320 (30.3%)	736 (69.7%)	383 (36.3%)	550 (52.1%)	
	2002 2003	276 (26.1%) 236 (23.2%)	782 (73.9%) • Medium patient volume and risk 421 (39.8%) 602 (56.9%) 783 (76.8%) 426 (41.8%) 619 (60.7%)	
	2 2004 2005 2006	24 201 (19.5%) 166 (15.6%) 136 (11.3%)	830 (80.5%) • Some teaching and/or research 432 (41.9%) 681 (66.1%) 897 (84.4%) 456 (42.9%) 790 (74.3%) • Level 2 facilities contain level 3 and 4 ICU units 1068 (88.7%) 584 (48.5%) 920 (76.4%)
	2007	121 (8.9%)	1231 (91.1%)	709 (52.4%)	1090 (80.6%)	
	2008 2009 2010	92 (6.2%) 94 (5.6%) 50 (4.3%)	1383 (93.8%) • Low levels of patient complexity 801 (54.3%) 1235 (83.7%) 1575 (94.4%) 880 (52.7%) 1419 (85.0%) • Smallest level in terms of volume 1125 (95.7%) 645 (54.9%) 1013 (86.2%)	
	2011	35 (3.0%)	• Little or no teaching/research 1121 (97.0%) 701 (60.6%) 1016 (87.9%)	
	3 2012 2013 Stage 2	31 38 (2.9%) 32 (3.1%)	1257 (97.1%) • Lowest number of physician specialists per pro-766 (59.2%) 1139 (88.0%) 1008 (96.9%) 596 (57.3%) 923 (88.8%) rated person
	2000 2001	21 (31.8%) 84 (33.2%)	45 (68.2%) • Level 3 facilities contain level 1 and 2 ICU units. 19 (28.8%) 32 (48.5%) 169 (66.8%) 88 (34.8%) 129 (51.0%)
	Excluded 2002 2003	53 (27.6%) 1 57 (22.5%)	139 (72.4%) 196 (77.5%)	79 (41.1%) 101 (39.9%)	106 (55.2%) 162 (64.0%)	
	Total HIV/AIDS 2004 2005	141 46 (18.9%) 43 (16.1%)	79(0.6%) 198 (81.1%) 224 (83.9%)	355(0.7%) 103 (38.6%) 196(0.8%) 91 (37.3%)	297(0.7%) 166 (68.0%) 188 (70.4%)	0.62
	374(3.1%) 250 (89.3%) 295 (94.6%) * P-values for comparisons of Any PET/CT versus PET/CT Never Performed for given categories. 2,418(4.7%) 1,286(5.0%) 2006 30 (10.7%) 121 (43.2%) Hepatitis C 2007 17 (5.4%) 143 (45.8%) 2008 14 (4.6%) 289 (95.4%) 154 (50.8%)	2,013(4.9%) 215 (76.8%) 250 (80.1%) 264 (87.1%)	<0.001
	2009	19 (5.6%)	320 (94.4%)	168 (49.6%)	286 (84.4%)	
	2010	28 (6.6%)	395 (93.4%)	215 (50.8%)	354 (83.7%)	
	2011	17 (4.5%)	365 (95.5%)	213 (55.8%)	330 (86.4%)	
	2012	20 (4.5%)	425 (95.5%)	233 (52.4%)	376 (84.5%)	
	2013	12 (3.6%)	317 (96.4%)	171 (52.0%)	287 (87.2%)	
	Stage 3					
	2000	109 (38.4%)	175 (61.6%)	77 (27.1%)	121 (42.6%)	
	2001	489 (38.1%)	796 (61.9%)	412 (32.1%)	568 (44.2%)	
	2002	436 (33.1%)	880 (66.9%)	422 (32.1%)	641 (48.7%)	
	2003	418 (32.1%)	883 (67.9%)	412 (31.7%)	674 (51.8%)	
	2004	380 (26.9%)	1035 (73.1%)	487 (34.4%)	802 (56.7%)	
	2005	293 (21.0%)	1102 (79.0%)	488 (35.0%)	898 (64.4%)	
	2006	196 (13.0%)	1306 (87.0%)	654 (43.5%)	1050 (69.9%)	

eFigure.*
Maya Vella, Craig S Meyer, Ning Zhang, Beth E Cohen, Mary A Whooley, Sunny Wang, Michael D Hope
Association of Receipt of Positron Emission Tomography–Computed Tomography With Non–Small Cell Lung Cancer Mortality in the Veterans Affairs Health Care System