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A prospective cohort study of shared decision making in lung cancer diagnostics: Impact of using a patient decision
Stine R Søndergaard1, Poul Henning Madsen2, Ole Hilberg3
1Department of Internal Medicine, The Lung Cancer Diagnostic Organization, Lillebaelt Hospital, Vejle, Denmark.
Objective:
The objective of this study was to describe the impact on patient-reported outcomes of introducing Shared Decision Making (SDM) and a Patient Decision Aid (PtDA) in the initial process of lung cancer diagnostics.
Methods:
We conducted a prospective cohort study, where a control cohort was consulted according to usual clinical practice. After introducing SDM through a PtDA and training of the staff, the SDM cohort was enrolled in the study. All patients completed four questionnaires: the Decisional Conflict Scale (DCS) before and after the consultation, the CollaboRATE scale after the consultation, and the Decision Regret Scale (DRS).
Results:
Patients exposed to SDM and a PtDA had significantly improved DCS scores after the consultation compared to the control group (a difference of 10.26, p = 0.0128) and significantly lower DRS scores (a difference of 8.98, p = 0.0197). Of the 82 control patients and 52 SDM patients 29% and 54%, respectively, gave the maximum score on the CollaboRATE scale (Pearson's chi2 8.0946, p = 0.004).
Conclusion:
The use of SDM and a PtDA had significant positive impact on patient-reported outcomes.
Practice Implications:
Our results may encourage the increased uptake of SDM in the initial process of lung cancer diagnostics.
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