Effect of a Patient Decision Aid on Lung Cancer Screening Decision-Making by Persons Who Smoke: A Randomized Clinical Trial
Robert J. Volk,Lisa M. Lowenstein,Viola B. Leal,Kamisha Hamilton Escoto,Scott B. Cantor,Reginald F. Munden,Vance Rabius,Linda Bailey,Paul M. Cinciripini,Heather Lin,Ashley J. Housten,Pamela Luckett,Angelina Esparza,Myrna C.B. Godoy,Therese B. Bevers +14 more
- Vol. 3, Iss: 1
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TLDR
This randomized clinical trial compares the effect of a patient decision aid on lung cancer screening vs standard educational information on decision-making outcomes among persons who smoke.Abstract:
Importance Lung cancer screening with low-dose computed tomography lowers lung cancer mortality but has potential harms. Current guidelines support patients receiving information about the benefits and harms of lung cancer screening during decision-making. Objective To examine the effect of a patient decision aid (PDA) about lung cancer screening compared with a standard educational material (EDU) on decision-making outcomes among smokers. Design, Setting, and Participants This randomized clinical trial was conducted using 13 state tobacco quitlines. Current and recent tobacco quitline clients who met age and smoking history eligibility for lung cancer screening were enrolled from March 30, 2015, to September 12, 2016, and followed up for 6 months until May 5, 2017. Data analysis was conducted between May 5, 2017, and September 30, 2018. Interventions Participants were randomized to the PDA videoLung Cancer Screening: Is It Right for Me?(n = 259) or to EDU (n = 257). Main Outcomes and Measures The primary outcomes were preparation for decision-making and decisional conflict measured at 1 week. Secondary outcomes included knowledge, intentions, and completion of screening within 6 months of receiving the intervention measured by patient report. Results Of 516 quit line clients enrolled, 370 (71.7%) were younger than 65 years, 320 (62.0%) were female, 138 (26.7%) identified as black, 47 (9.1%) did not have health insurance, and 226 (43.8%) had a high school or lower educational level. Of participants using the PDA, 153 of 227 (67.4%) were well prepared to make a screening decision compared with 108 of 224 participants (48.2%) using EDU (odds ratio [OR], 2.31; 95% CI, 1.56-3.44;P Conclusions and Relevance In this study, a PDA delivered to clients of tobacco quit lines improved informed decision-making about lung cancer screening. Many smokers eligible for lung cancer screening can be reached through tobacco quit lines. Trial Registration ClinicalTrials.gov identifier:NCT02286713read more
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Addressing Disparities in Lung Cancer Screening Eligibility and Healthcare Access. An Official American Thoracic Society Statement.
M. Patricia Rivera,Hormuzd A. Katki,Nichole T. Tanner,Matthew Triplette,Lori C. Sakoda,Renda Soylemez Wiener,Roberto Cardarelli,Lisa Carter-Harris,Kristina Crothers,Joelle T. Fathi,Marvella E. Ford,Robert A. Smith,Robert A. Winn,Juan P. Wisnivesky,Louise M. Henderson,Melinda C. Aldrich +15 more
TL;DR: The impact of LCS eligibility criteria on vulnerable populations who are at increased risk of lung cancer but do not meet eligibility criteria for screening, as well as multiple barriers that contribute to disparities in LCS implementation are identified.
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Effect of a Telecare Case Management Program for Older Adults Who Are Homebound During the COVID-19 Pandemic: A Pilot Randomized Clinical Trial.
TL;DR: In this article, the authors evaluated the effectiveness of telecare case management for older adults who are homebound during the COVID-19 pandemic, and found that the telecare group had better medication adherence and quality of life than the control group, although the small sample size may limit generalizability.
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Tools to Promote Shared Decision-Making in Lung Cancer Screening Using Low-Dose CT Scanning: A Systematic Review.
Mayuko Fukunaga,Kyle Halligan,Jennifer Kodela,Shaun Toomey,Vanessa Fiorini Furtado,Roger Luckmann,Paul Kyu Han,Kathleen M. Mazor,Sonal Singh +8 more
TL;DR: Evidence from 14 studies suggests that some elements of existing tools for lung cancer screening may help to prepare patients for decision-making by improving knowledge and reducing decisional conflict.
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Understanding the Implications of Medicaid Expansion for Cancer Care in the US: A Review.
Theresa Ermer,Theresa Ermer,Theresa Ermer,Samantha L. Walters,Maureen E. Canavan,Michelle C. Salazar,Andrew X. Li,Michael Doonan,Daniel J. Boffa +8 more
TL;DR: In this paper, the authors provide an overview of the fundamental principles and nuances of Medicaid expansion, as well as the implications for cancer care, including the implications of cancer treatment and outcomes on the US cancer population.
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