Daniel Reuland|Laura Cubillos|Alison T. Brenner|Russell Harris|Bailey Minish|Michael Pignone
A pre-post study testing a lung cancer screening decision aid in primary care
University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|The University of Texas at Austin
united states preventive services task force uspstf issued recommendations older heavy lifetime smokers complete annual lowdose computed tomography ldct scans chest screening lung cancer uspstf recommends centers medicare medicaid services require shared decision making using decision aid lung cancer screening annual ldct little known decision aids affect screening knowledge preferences behavior thus tested lung cancer screening decision aid video screeningeligible primary care patientswe conducted singlegroup study surveys decision aid viewing medical record review 3 months participants active patients large us academic primary care practice current former smokers ages 5580 years eligible screening based current screening guidelines outcomes assessed prepost decision aid viewing screeningrelated knowledge score 9 items screeningrelated harms false positives overdiagnosis likelihood benefit score range 09 preference preferred screening vs screening behavior measures assessed via chart review included provider visits screening discussion ldct ordering ldct completion within 3 monthsamong 50 participants knowledge increased pre postdecision aid viewing mean 26 vs 55 difference 28 95 ci 21 36 p 0001 preferences across overall sample remained similar 54 preferred screening baseline 50 viewing however 28 participants changed preference away screening baseline viewing assessed screening behavior 36 participants primary care visit 3month period following enrollment eighteen 36 preferred screening decision aid viewing 18 10 discussed screening 8 test ordered 6 completed ldct among 18 preferred screening 7 discussed screening 5 test ordered 4 completed ldctin primary care patients lung cancer screening decision aid improved knowledge regarding screeningrelated benefits harms screening preferences behavior heterogeneousthis study registered wwwclinicaltrialsgov nct03077230 registered retrospectivelynovember 22 2016