Lung Cancer Screening Decision Aid Designed for a Primary Care Setting: A Randomized Clinical Trial.

Area of Science:

• Clinical Trials
• Health Services Research
• Decision Science

Background:

• Shared decision-making is recommended before lung cancer screening (LCS).
• Evidence on implementing shared decision-making tools in clinical practice is limited.
• A web-based decision support tool was developed to aid LCS decision-making.

Purpose of the Study:

• To evaluate the impact of a lung cancer screening decision tool (LCSDecTool) on decision quality and LCS uptake.
• To assess decisional conflict, knowledge, regret, and anxiety related to LCS.
• To determine the effect of the LCSDecTool on LCS uptake within six months.

Main Methods:

• A randomized clinical trial was conducted across three Veteran Affairs Medical Centers.
• Participants aged 55-80 with a significant smoking history were randomized to the LCSDecTool or an attention control.
• Primary outcome was decisional conflict at 1 month; secondary outcomes included knowledge and LCS uptake at 6 months.

Main Results:

• No significant difference in decisional conflict was observed between groups at 1 month.
• The LCSDecTool group demonstrated significantly greater knowledge of LCS immediately after intervention and at 1 and 3 months.
• LCS uptake was significantly higher in the LCSDecTool group at 6 months (37.7% vs 21.1%).

Conclusions:

• The LCSDecTool did not significantly reduce decisional conflict at 1 month.
• The intervention effectively increased participant knowledge and lung cancer screening uptake.
• Findings support the use of LCSDecTool to enhance shared decision-making and improve LCS rates.