Dr. Farhood Farjah is a thoracic surgeon and clinical researcher dedicated to improving individual and population health. His research has largely focused on improving care delivery and outcomes for lung cancer patients, with a particular interest in the utilization of diagnostic tests for screening, staging, and surveillance. He has used large databases, risk prediction, biomarkers, and more recently natural language processing to facilitate his research goals. Dr. Farjah seeks to disseminate and implement advances in scientific knowledge through evidence generation, education, stakeholder engagement, development of clinical tools (e.g. risk calculators), quality improvement initiatives, and health policy.

Dr. Farjah's NCI R01 funded project is a comparative-effectiveness study aiming to understand the relationship, if any, between outcomes and the intensity of a diagnostic work-up for an incidentally (not screen) detected lung nodule. This work is significant because it has the potential to impact the lives of 1.5 million people per year diagnosed with an incidentally detected lung nodule. Most of these individuals do not have lung cancer, but failing to identify those who do is a missed opportunity for early detection and treatment of lung cancer. In order to balance the benefits and harms of an evaluation inclusive of both invasive and non-invasive diagnostic modalities, practice guidelines provide recommendations for varying intensities of work-up depending on crude estimates of an individual's risk of lung cancer (e.g. using age and smoking status). These guidelines are largely supported by low levels of evidence and expert opinion. Dr. Farjah's study addresses an important knowledge gap in the field—specifically whether guideline-recommended care is associated with better patient outcomes. If indeed guideline recommendations are associated with better outcomes, then there is substantial opportunity to improve care through novel interventions aimed at increasing guideline adherence (current rates of adherence are ~50% in the community-at-large). If guideline recommendations are not associated with better outcomes, then there is an opportunity to improve care through novel diagnostic algorithms for evaluating incidentally detected lung nodules (e.g. using risk-prediction models and/or biomarkers). Dr. Farjah's interest in pulmonary nodules stems from the growing number of individuals that he (and many other providers) see in clinical practice with an incidentally detected lung nodule, and great uncertainty about the effect of guideline recommendations on patient outcomes. He would not have been able to pursue this work without the support, mentorship, and research infrastructure provided by the Cancer Research Network Scholars Program and Pilot Grant.