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Related Experiment Video

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Values Clarification Methods in Decision Support Tools for Lung Cancer Screening: A Systematic Review and Content

Norah L Crossnohere1, Rosa Negash1, Manny Schwimmer1

  • 1Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA.

Medical Decision Making : an International Journal of the Society for Medical Decision Making
|August 17, 2025
PubMed
Summary
This summary is machine-generated.

Decision support tools for lung cancer screening (LCS) commonly use values clarification, increasing screening uptake. However, theory-based methods for explicit values clarification are underutilized, limiting potential improvements in decision support quality.

Keywords:
early detection of cancerlung neoplasmspatient preferencesshared decision making

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Area of Science:

  • Medical Informatics
  • Public Health
  • Decision Science

Background:

  • Values clarification is crucial for shared decision-making, especially in lung cancer screening (LCS) due to complex benefit-harm trade-offs.
  • Explicit, theory-based values clarification methods are hypothesized to best support patient decision-making.

Purpose of the Study:

  • To characterize values clarification methods in patient-facing LCS decision support tools.
  • To explore associations between these methods and behavioral/decisional outcomes.

Main Methods:

  • Systematic review of 48 studies evaluating 32 unique LCS decision support tools.
  • Data extraction on study characteristics and values clarification methods (explicit, implicit, none).
  • Meta-analysis of randomized controlled trials (RCTs) to assess tool impact on LCS uptake.

Main Results:

  • Over 80% of LCS decision support tools included values clarification (50% explicit, 50% implicit).
  • RCTs showed decision support tools doubled LCS odds (OR 1.98), driven by explicit or no values clarification.
  • Tools lacking values clarification were of lower quality; theory-based explicit methods were rarely used.

Conclusions:

  • LCS decision support tools frequently incorporate values clarification and enhance screening uptake.
  • Underutilization of theory-based explicit values clarification methods limits potential improvements in decision support quality.