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What is the effect of a decision aid on knowledge, values and preferences for lung cancer screening? An online
Stephen D Clark1, Daniel S Reuland2, Alison T Brenner2
1Division of General Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, USA stephen.clark1@vcuhealth.org.
Objective:
To examine if a decision aid improves knowledge of lung cancer screening benefits and harms and which benefits and harms are most valued.
Design:
Pre-post study.
Setting:
Online.
Participants:
219 current or former (quit within the previous 15 years) smokers ages 55-80 with at least 30 pack-years of smoking.
Intervention:
Lung cancer screening video decision aid.
Main Measures:
Screening knowledge tested by 10 pre-post questions and value of benefits and harms (reducing chance of death from lung cancer, risk of being diagnosed, false positives, biopsies, complications of biopsies and out-of-pocket costs) assessed through rating (1-5 scale) and ranking (top three ranked).
Results:
Mean age was 64.7±6.1, 42.5% were male, 75.4% white, 48.4% married, 28.9% with less than a college degree and 67.6% with income
Conclusions:
Our decision aid increased lung cancer screening knowledge among a diverse sample of screen-eligible respondents. Although a majority valued 'reducing the chance of death from lung cancer' highest, a substantial proportion identified harms as most important. Knowledge improvement and ranking harms highest were associated with lower intention to screen.
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