To develop meaningful quality indicators in lung cancer, the Thoracic Oncology Network of the ACCP has nearly completed a project to develop quality indicators for the pretreatment evaluation of patients with lung cancer (P. Mazzone, MD, FCCP, personal communication, June 10, 2013). The committee reviewed all available evidence-based guidelines to provide a basis for the indicators. From this review, seven indicators were chosen according to their validity (connection to improved outcomes), feasibility (ability to obtain information from the medical records related to the indicator), and relevance (potential for poor or variable performance of the indicators). Not surprising, one of them is mediastinal staging as the first invasive test in suspected lung cancer. Objectively measuring compliance and reporting outcomes would provide a concrete context for increasing physician effort to improve staging practices.