A pre-post study testing a lung cancer screening decision aid in primary care

Area of Science:

• Preventive medicine
• Health communication
• Medical decision-making

Background:

• The United States Preventive Services Task Force (USPSTF) recommends annual low-dose computed tomography (LDCT) screening for lung cancer in high-risk individuals.
• Shared decision-making using decision aids is required for lung cancer screening with LDCT.
• The impact of decision aids on screening knowledge, preferences, and behavior is not well understood.

Purpose of the Study:

• To evaluate the effectiveness of a lung cancer screening decision aid video in primary care patients eligible for screening.
• To assess changes in screening knowledge, preferences, and behavior after viewing the decision aid.

Main Methods:

• A single-group study involving surveys administered before and after decision aid viewing.
• Participants were eligible primary care patients (smokers aged 55-80) from a large US academic practice.
• Outcomes included knowledge scores, screening preferences, and screening behavior (discussion, LDCT order, completion) assessed via chart review at 3 months.

Main Results:

• Fifty participants showed a significant increase in knowledge regarding lung cancer screening benefits and harms (mean score 2.6 to 5.5).
• While overall screening preferences remained similar (54% at baseline vs. 50% post-viewing), 28% of participants changed their preference.
• Among those with a primary care visit within 3 months, screening behavior (discussion, ordering, completion) was observed in a subset of participants, with variations based on post-viewing preference.

Conclusions:

• A lung cancer screening decision aid video effectively improved knowledge about screening-related benefits and harms in primary care patients.
• Screening preferences and subsequent behaviors demonstrated heterogeneity among participants.
• Decision aids play a role in informing patient choices regarding lung cancer screening.