Computer-Tailored Decision Support Tool for Lung Cancer Screening: Community-Based Pilot Randomized Controlled Trial

Area of Science:

• Public Health
• Medical Decision Making
• Health Informatics

Background:

• Lung cancer screening is a US Preventive Services Task Force Grade B recommendation, reducing mortality by ~20%.
• Shared decision-making (SDM) is crucial for lung cancer screening but challenging due to low awareness and potential risks like false positives.
• Effective patient preparation and clinician support are needed for informed lung cancer screening decisions.

Purpose of the Study:

• To evaluate a computer-tailored decision support tool (LungTalk) for lung cancer screening.
• To assess the tool's impact on patient preparedness and SDM for lung cancer screening.
• To meet International Patient Decision Aid Standards certification criteria.

Main Methods:

• A pilot randomized controlled trial involved 60 screening-eligible participants with no prior screening.
• Participants were randomized to view either the web-based LungTalk tool or generic information.
• Outcomes measured included knowledge, health beliefs, and perceived preparedness for discussion.

Main Results:

• Both groups showed increased knowledge, with significantly greater improvement in the LungTalk group (2.33 vs 1.14 mean change).
• Perceived self-efficacy and perceived benefits improved as theoretically predicted.
• LungTalk enhanced preparedness for engaging in lung cancer screening discussions.

Conclusions:

• LungTalk effectively prepares individuals for lung cancer screening decisions by providing tailored information.
• The tool addresses broader lung health and potential incidental findings from low-dose CT scans.
• Tailoring algorithms and message framing based on smoking status enhance its impact on behavior change.