Miranda Tan, DO

All Publications

• The Impact of Healthcare Disparities on Lung Cancer Screening and Treatment. Chest Bade, B., Faiz, S. A., Tan, M., Baugh, A. D., Lavercombe, M., Sheshadri, A. 2025

  Abstract

  From screening to treatment, the continuum of lung cancer care suffers from unequal access and delivery, with more vulnerable patients less able to receive high-quality care. Despite great advances in lung cancer care (e.g., screening and nodule programs to identify early-stage disease and immune-mediated and targeted therapies for advanced-stage disease), disparities persist both in the United States and globally. In this narrative review, the spectrum of disparities that influence lung cancer care on a national scale, including race, ethnicity, age, socioeconomic status, geographic location, and insurance access are explored. The review focuses on how disparities impact screening efforts and lung cancer treatments. Where data are available, trends on a global scale are addressed. Potential solutions are offered to address recognized disparities, primarily by identifying pertinent social determinants of health and launching multi-pronged interventions to improve the care of all patients who develop lung cancer.

  View details for DOI 10.1016/j.chest.2025.05.004

  View details for PubMedID 40350147

• Treatment of obstructive sleep apnea with CPAP improves daytime sleepiness and fatigue in cancer patients. Cancer medicine Ganjaei, K. G., Wong, K. A., Strauss, S. M., Carlsson, S. V., Barton-Burke, M., Tan, M. 2024; 13 (21): e7198

  Abstract

  Fatigue and sleep disorders are prevalent in cancer patients. Obstructive sleep apnea (OSA) commonly causes excessive daytime sleepiness (EDS) and fatigue. We hypothesize that treating cancer patients with OSA using positive airway pressure (PAP) will improve EDS and fatigue.A retrospective chart review of sleep clinic visits of cancer patients with newly diagnosed OSA was performed. Epworth Sleepiness Scale (ESS) and fatigue reported at baseline and within 6 months of starting PAP therapy were compared between PAP-adherent and PAP-non-adherent patients.65 cancer patients with OSA and ESS >10 were recommended PAP therapy, including 45 patients with fatigue. 29 patients pursued PAP therapy with 79% (n = 23) adherent at follow-up. The median baseline apnea hypopnea index (AHI) for OSA was 24.0 (interquartile range [IQR] 14.3, 32.3) and 23.8 (IQR 10.1, 42.8) events/hour among PAP-adherent and PAP-non-adherent patients, respectively (p = 0.90). Median baseline ESS was 14.0 (IQR 12.0, 17.0) among adherent and 17.0 (IQR 11.0, 17.3) among non-adherent patients (p = 0.73). The median ESS at follow-up of the adherent and non-adherent groups was 8.0 (IQR 6.0, 10.0) and 11.0 (IQR 8.0, 15.8), respectively (p = 0.08). Median ESS change was -5.0 (IQR -7.0, -4.0) in PAP adherent patients and -2.5 (IQR -5.25, -1.50) in PAP-non-adherent patients (p = 0.07). When the groups are examined separately, the median change in the PAP-adherent group was highly significant (p = 0.001), while the ESS median change in the PAP-non-adherent group was considerably less (p = 0.04). 17 out of the 21 PAP-adherent patients reporting fatigue at baseline indicated improvement at follow-up.PAP therapy for OSA in cancer patients improves EDS and fatigue. Larger studies are necessary to evaluate the efficacy of PAP in improving fatigue in this population.

  View details for DOI 10.1002/cam4.7198

  View details for PubMedID 39475167

  View details for PubMedCentralID PMC11523141

• Cancer-related Fatigue in Lung Cancer: A Research Agenda: An Official American Thoracic Society Research Statement. American journal of respiratory and critical care medicine Bade, B. C., Faiz, S. A., Ha, D. M., Tan, M., Barton-Burke, M., Cheville, A. L., Escalante, C. P., Gozal, D., Granger, C. L., Presley, C. J., Smith, S. M., Chamberlaine, D. M., Long, J. M., Malone, D. J., Pirl, W. F., Robinson, H. L., Yasufuku, K., Rivera, M. P. 2023; 207 (5): e6-e28

  Abstract

  Background: Fatigue is the most common symptom among cancer survivors. Cancer-related fatigue (CRF) may occur at any point in the cancer care continuum. Multiple factors contribute to CRF development and severity, including cancer type, treatments, presence of other symptoms, comorbidities, and medication side effects. Clinically, increasing physical activity, enhancing sleep quality, and recognizing sleep disorders are integral to managing CRF. Unfortunately, CRF is infrequently recognized, evaluated, or treated in lung cancer survivors despite more frequent and severe symptoms than in other cancers. Therefore, increased awareness and understanding of CRF are needed to improve health-related quality of life in lung cancer survivors. Objectives: 1) To identify and prioritize knowledge and research gaps and 2) to develop and prioritize research questions to evaluate mechanistic, diagnostic, and therapeutic approaches to CRF among lung cancer survivors. Methods: We convened a multidisciplinary panel to review the available literature on CRF, focusing on the impacts of physical activity, rehabilitation, and sleep disturbances in lung cancer. We used a three-round modified Delphi process to prioritize research questions. Results: This statement identifies knowledge gaps in the 1) detection and diagnostic evaluation of CRF in lung cancer survivors; 2) timing, goals, and implementation of physical activity and rehabilitation; and 3) evaluation and treatment of sleep disturbances and disorders to reduce CRF. Finally, we present the panel's initial 32 research questions and seven final prioritized questions. Conclusions: This statement offers a prioritized research agenda to 1) advance clinical and research efforts and 2) increase awareness of CRF in lung cancer survivors.

  View details for DOI 10.1164/rccm.202210-1963ST

  View details for PubMedID 36856560

• Screening for Obstructive Sleep Apnea in Patients with Cancer – a Machine Learning Approach Screening for Obstructive Sleep Apnea in Patients with Cancer – a Machine Learning Approach Wong, K. A., Paul, A., Fuentes, P., Lim, D. C., Das, A., Tan, M. 2023
• Counting electric sheep: Dreaming of AI in sleep medicine Counting electric sheep: Dreaming of AI in sleep medicine Tan, M., Bhargava, S. 2023
• A patient with gastroesophageal junction carcinoma and cough. Lung India : official organ of Indian Chest Society Makkar, P. S., Mehta, V., Tan, M. 2021; 38 (2): 193-194

  Abstract

  A 40-year-old, never smoker male with gastroesophageal junction carcinoma was evaluated for dyspnea and cough. Computed tomography scan was obtained which showed ground-glass opacities surrounded by rim of consolidation (Atoll sign). The patient underwent bronchoscopy with transbronchial lung biopsy and was diagnosed with organizing pneumonia secondary to checkpoint inhibitor toxicity.

  View details for DOI 10.4103/lungindia.lungindia_520_19

  View details for PubMedID 33687017

  View details for PubMedCentralID PMC8098891

• OSA in Professional Transport Operations: Safety, Regulatory, and Economic Impact. Chest Gurubhagavatula, I., Tan, M., Jobanputra, A. M. 2020; 158 (5): 2172-2183

  Abstract

  OSA is common among commercial vehicle operators (CVOs) in all modes of transportation, including truck, bus, air, rail, and maritime operations. OSA is highly prevalent and increases the risk of drowsiness-related crashes in CVOs. Internationally, specific regulations regarding its identification and management vary widely or do not exist; medical examiners and sleep medicine specialists are urged to use available guidance documents in their absence. Education, screening, prompt identification and treatment, and ongoing surveillance to ensure effective therapy can lower the risk of fatigue-related crashes.

  View details for DOI 10.1016/j.chest.2020.05.582

  View details for PubMedID 32540304

• Obstructive sleep apnea in commercial motor vehicle operators SLEEP AND HEALTH Gurubhagavatula, I., Jobanputra, A. M., Tan, M., Grandner, M. A. 2019: 481-487

  View details for DOI 10.1016/B978-0-12-815373-4.00036-8

  View details for Web of Science ID 000483503400037

• Shaking Up Perspectives of Restless Legs Syndrome in Pregnancy. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine Tan, M., Bourjeily, G. 2017; 13 (7): 857-858

  View details for DOI 10.5664/jcsm.6648

  View details for PubMedID 28633718

  View details for PubMedCentralID PMC5482574

• One-Third of Patients With “Asthma” in the Community May Not Currently Have Asthma One-Third of Patients With “Asthma” in the Community May Not Currently Have Asthma Tan, M., West, F., Zappetti, D. 2017

  View details for DOI 10.1097/CPM.0000000000000223

• Positive Airway Pressure Therapy for Sleep Disordered Breathing in Congestive Heart Failure is Associated with Reduction in Pulmonary Artery Systolic Pressure Positive Airway Pressure Therapy for Sleep Disordered Breathing in Congestive Heart Failure is Associated with Reduction in Pulmonary Artery Systolic Pressure Tan, M., Tavela , R., Lee, K., Willes , L., Mather , P. 2016

  View details for DOI 10.4172/2325-9639.1000170

• High-Resolution Pulse Oximetry: Cost Effective Tool to Screen Sleep-Disordered Breathing in the Hospitalized Patients High-Resolution Pulse Oximetry: Cost Effective Tool to Screen Sleep-Disordered Breathing in the Hospitalized Patients Sharma , S., Tan , M. 2016

  View details for DOI 10.4172/2325-9639.S1-002