Yan Kwan Lau1, Tanner J Caverly2, Pianpian Cao1, Sarah T Cherng1, Mindy West1, Charles Gaber1, Douglas Arenberg3, Rafael Meza4. 1. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan. 2. Division of General Internal Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan; Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan. 3. Division of Pulmonary and Critical Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan. 4. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan. Electronic address: rmeza@umich.edu.
Abstract
INTRODUCTION: Informed decision making has been highlighted as an important aspect of lung cancer screening programs. This study seeks to assess the efficacy of a web-based patient decision aid for lung cancer screening, www.shouldiscreen.com. METHODS: A before-and-after study (August through December 2014) was conducted where participants navigated a web-based decision aid that provided information about low-dose computed tomography lung cancer screening. Using an established prediction model, the decision aid computed baseline lung cancer risk and an individual's chances of benefiting from, and risk of being harmed by, screening. Outcome measures included knowledge of lung cancer risk factors and lung cancer screening, decisional conflict, concordance, and acceptability of the decision aid. Data were collected from 60 participants who were current or former smokers, had no history of lung cancer, and had not received a chest computed tomographic scan in the previous year. Analysis took place in 2015. RESULTS: Knowledge increased after seeing the decision aid compared with before (p<0.001), whereas the score on the Decisional Conflict Scale decreased (p<0.001). Concordance between a participant's preference to screen and the U.S. Preventive Services Task Force recommendation improved after seeing the decision aid (p<0.001). Risk perceptions among the screen-ineligible group changed (n=49), contrary to those who were eligible (n=11). Ninety-seven percent of the participants reported that the decision aid was likely useful for lung cancer screening decision making. CONCLUSIONS: The web-based decision aid should be a helpful resource for individuals considering lung cancer screening, as well as for practitioners and health systems with lung cancer screening programs.
INTRODUCTION: Informed decision making has been highlighted as an important aspect of lung cancer screening programs. This study seeks to assess the efficacy of a web-based patient decision aid for lung cancer screening, www.shouldiscreen.com. METHODS: A before-and-after study (August through December 2014) was conducted where participants navigated a web-based decision aid that provided information about low-dose computed tomography lung cancer screening. Using an established prediction model, the decision aid computed baseline lung cancer risk and an individual's chances of benefiting from, and risk of being harmed by, screening. Outcome measures included knowledge of lung cancer risk factors and lung cancer screening, decisional conflict, concordance, and acceptability of the decision aid. Data were collected from 60 participants who were current or former smokers, had no history of lung cancer, and had not received a chest computed tomographic scan in the previous year. Analysis took place in 2015. RESULTS: Knowledge increased after seeing the decision aid compared with before (p<0.001), whereas the score on the Decisional Conflict Scale decreased (p<0.001). Concordance between a participant's preference to screen and the U.S. Preventive Services Task Force recommendation improved after seeing the decision aid (p<0.001). Risk perceptions among the screen-ineligible group changed (n=49), contrary to those who were eligible (n=11). Ninety-seven percent of the participants reported that the decision aid was likely useful for lung cancer screening decision making. CONCLUSIONS: The web-based decision aid should be a helpful resource for individuals considering lung cancer screening, as well as for practitioners and health systems with lung cancer screening programs.
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