Decision Support Tools for Low-Dose CT Lung Cancer Screening: A Scoping Review of Information Content, Format, and...

Area of Science:

• Public Health
• Health Communication
• Medical Decision Making

Background:

• Informed or shared decision-making is mandated for low-dose CT (LDCT) lung cancer screening in several countries.
• Limited knowledge exists regarding the specific information and presentation techniques used in practice for LDCT screening decision support.

Purpose of the Study:

• To characterize the content, format, mode, and presentation methods of decision support tools (DSTs) for LDCT lung cancer screening.
• To identify variations in DST design and their potential impact on decision-making quality.

Main Methods:

• Systematic review of peer-reviewed articles (January 2000-April 2021) from major databases (PubMed, PsycInfo, EMBASE, CINAHL Plus).
• Inclusion criteria focused on resources or tools supporting individual or shared decision-making for LDCT lung cancer screening.
• Data extraction framework based on International Patient Decision Aids Standards and Template for Intervention Description and Reporting.

Main Results:

• Identified 22 DSTs (paper, video, electronic) across 26 articles.
• Most DSTs focused on knowledge exchange (n=13); fewer used interactive techniques for values clarification (n=7) or deliberation (n=9).
• Significant variation in detail, probability quantification, and presentation methods; none described all potential harms and results.

Conclusions:

• Heterogeneity in DST design may impact decision-making quality, especially for individuals with lower literacy and numeracy.
• Development of evidence-based consensus guidelines for DST content and presentation is recommended.
• Collaborative development of guidelines with screening-eligible adults is essential for effective implementation.