Computer-Tailored Decision Support Tool for Lung Cancer Screening: Community-Based Pilot Randomized Controlled Trial

Autor:	James E. Slaven, DuyKhanh Pham Ceppa, Emilee Vode, Robert Skipworth Comer, Susan M. Rawl, Nasser H. Hanna, Patrick O. Monahan, Lisa Carter-Harris
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	Male medicine.medical_specialty Decision support system Lung Neoplasms Decision Making Health Informatics Pilot Projects lcsh:Computer applications to medicine. Medical informatics patient education Decision Support Techniques 03 medical and health sciences 0302 clinical medicine patient decision aid Residence Characteristics Cancer screening lung cancer screening Decision aids Medicine Humans 030212 general & internal medicine Overdiagnosis Lung cancer Early Detection of Cancer Original Paper business.industry 030503 health policy & services lcsh:Public aspects of medicine shared decision-making Cancer lcsh:RA1-1270 Middle Aged medicine.disease Telemedicine informed decision-making Family medicine lcsh:R858-859.7 Female 0305 other medical science business Lung cancer screening Patient education
Zdroj:	Journal of Medical Internet Research Journal of Medical Internet Research, Vol 22, Iss 11, p e17050 (2020)
ISSN:	1438-8871 1439-4456
Popis:	Background Lung cancer screening is a US Preventive Services Task Force Grade B recommendation that has been shown to decrease lung cancer-related mortality by approximately 20%. However, making the decision to screen, or not, for lung cancer is a complex decision because there are potential risks (eg, false positive results, overdiagnosis). Shared decision making was incorporated into the lung cancer screening guideline and, for the first time, is a requirement for reimbursement of a cancer screening test from Medicare. Awareness of lung cancer screening remains low in both the general and screening-eligible populations. When a screening-eligible person visits their clinician never having heard about lung cancer screening, engaging in shared decision making to arrive at an informed decision can be a challenge. Methods to effectively prepare patients for these clinical encounters and support both patients and clinicians to engage in these important discussions are needed. Objective The aim of the study was to estimate the effects of a computer-tailored decision support tool that meets the certification criteria of the International Patient Decision Aid Standards that will prepare individuals and support shared decision making in lung cancer screening decisions. Methods A pilot randomized controlled trial with a community-based sample of 60 screening-eligible participants who have never been screened for lung cancer was conducted. Approximately half of the participants (n=31) were randomized to view LungTalk—a web-based tailored computer program—while the other half (n=29) viewed generic information about lung cancer screening from the American Cancer Society. The outcomes that were compared included lung cancer and screening knowledge, lung cancer screening health beliefs (perceived risk, perceived benefits, perceived barriers, and self-efficacy), and perception of being prepared to engage in a discussion about lung cancer screening with their clinician. Results Knowledge scores increased significantly for both groups with greater improvement noted in the group receiving LungTalk (2.33 vs 1.14 mean change). Perceived self-efficacy and perceived benefits improved in the theoretically expected directions. Conclusions LungTalk goes beyond other decision tools by addressing lung health broadly, in the context of performing a low-dose computed tomography of the chest that has the potential to uncover other conditions of concern beyond lung cancer, to more comprehensively educate the individual, and extends the work of nontailored decision aids in the field by introducing tailoring algorithms and message framing based upon smoking status in order to determine what components of the intervention drive behavior change when an individual is informed and makes the decision whether to be screened or not to be screened for lung cancer. International Registered Report Identifier (IRRID) RR2-10.2196/resprot.8694
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::31fc884f6ba4c37ed9c8f86fcba682a8 http://europepmc.org/articles/PMC7671845 Zobrazit plný text záznamu Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.