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Shared Decision-Making for Lung Cancer Screening: How Well Are We "Sharing"?
Shawn P E Nishi1, Lisa M Lowenstein2, Tito R Mendoza3
1Department of Internal Medicine, Division of Pulmonary Critical Care and Sleep Medicine, The University of Texas Medical Branch, Galveston, TX.
Shared decision-making (SDM) in lung cancer screening (LCS) is variable. Patients often receive unbalanced information on benefits versus harms, highlighting a need for improved decision aids to enhance SDM quality.
Area of Science:
- Pulmonary Medicine
- Health Services Research
- Patient Decision Making
Background:
- Lung cancer screening (LCS) reduces mortality but involves risks.
- Shared decision-making (SDM) is crucial for patient engagement in LCS.
Purpose of the Study:
- To assess the quality of SDM among patients recently evaluated for LCS.
- To identify factors influencing SDM in LCS.
Main Methods:
- Cross-sectional study of 266 patients from two US academic centers.
- Surveys assessed demographics, values, knowledge, SDM components, and decisional conflict.
Main Results:
- Patients showed limited LCS knowledge (41.4% correct answers).
- Benefits were presented more often than harms (68.3% vs. 20.8%).
- Educational material use was low (30.7%), and decisional conflict was present in 33.6%.
Conclusions:
- SDM quality in LCS is inconsistent.
- Imbalanced information and low use of decision aids are concerns.
- Structured approaches with decision aids could improve SDM quality.
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