Table 5. Overview of patient decision aids for lung cancer screening.
| Name of aid; developers; date of release/publication | Format of aid | Availability | Overview of content | Evaluation data |
|---|---|---|---|---|
| LuCaS DA; Jamie L. Studts, University of Kentucky; Under testing (study start date: March 2016) | Interactive, web-based aid | Not yet available | Includes the following sections: Knowledge: potential benefits and risks and personal risks assessment; Empowerment: encourages active communication of patients with clinicians; Value clarification: informs patients how they relate to the screening personally (46) |
Increased knowledge of LDCT and LCS guidelines from initial to the 2-week follow-up |
| Mean decisional conflict decreased from 39.3 (SD, 13.5) to 34.4 (SD, 11.1) | ||||
| Percentage of participants stated to have made a decision about screening increased from 32.7% to 37.5% | ||||
| LuCaS DA improves some behavioral outcomes, but not consistently better than the NCI webpages (47) | ||||
| shouldiscreen.com (www.shouldiscreen.com); University of Michigan; October 2015 | Interactive, web-based aid | Available online | Information about lung cancer and LDCT | Knowledge increased after navigating the DA (P<0.001) |
| Costs and benefits of screening | 82% (n=49) thought the DA included enough information to help making decisions on screening | |||
| Comparison with other screening tests for other cancers | Mean decisional conflict scale score was 46.33 (SD, 29.69) prior to viewing the tool, and 15.08 (SD, 25.78) after (P<0.001) | |||
| Personalized estimates of baseline lung cancer risk and benefit and risks of being harmed by screening | Concordance between a participant’s preference to screening and the USPSTF recommendation improved (24% to 59%, P<0.001) (48) | |||
| “Lung Cancer Screening: Is it right for me?”; Robert J. Volk, The University of Texas MD Anderson Cancer Center; June 2012 | Video-based patient decision aid in DVD format or web-enabled video | Copies available to patients at MD Anderson Cancer Center | Eligibility criteria | Currently under evaluation with results expected in 2018 |
| Overview of screening | ||||
| Visual display of magnitude of harms and risks | ||||
| Value clarification | ||||
| Visual display of smoking cessation message | ||||
| CHOICE: Should I start having yearly screening for lung cancer; Daniel S. Reuland, UNC Lineberger Comprehensive Cancer Center; May 2015 (Pilot Study Start Date) | Interactive, web-based decision aid | Not yet available | Review of lung cancer and LCS | The percentage of participants (n=41) having intentions to initiate LCS decreased from 66% to 54%, (95% CI, −0.09%, 33%) |
| Visual display of benefits and harms of LDCT (e.g., false-positives, radiation, stress/anxiety) (49) | Greater knowledge was marginally associated with lower screening intent [OR, 0.68 (95% CI, 0.46, 1.00)] (50) | |||
| Value clarification | ||||
| Screening choices | ||||
| Smoking cessation messaging | ||||
| Is Lung Cancer Screening Right for Me? A Decision Aid for People Considering Lung Cancer Screening with Low-Dose Computed Tomography (https://effectivehealthcare.ahrq.gov/decision-aids/lung-cancer-screening/patient.html); Agency for Healthcare Research and Quality; March 2016 | Interactive, web-based aid | Available online | Eligibility criteria | The effectiveness of the DA has not been evaluated (51) |
| Facts and possible symptoms of lung cancer | ||||
| Reviews of LDCT and benefits and harms of screening | ||||
| Smoking cessation information | ||||
| Value clarification | ||||
| Yearly Lung Cancer Screening: Is It Right for Me? (https://siteman.wustl.edu/wp-content/uploads/2016/04/Lung-Cancer-Screening-20160427_rev.pdf); Mary C. Politi and Pamela Samson, Washington University Siteman Cancer Center; April 2016 | Brochure | Available online | Evidence-based summary of LCS vs. no screening | The effectiveness of the DA has not been evaluated (52) |
| Screening eligibility | ||||
| Pros and cons of screening choice | ||||
| Symptoms of lung cancer | ||||
| Smoking cessation information | ||||
| Estimates of baseline lung cancer risk | ||||
| HealthDecision Chest CT for Lung Cancer- Lung Cancer Screening Decision Support Tool (https://www.healthdecision.org/tool.html#/tool/lungca); HealthDecision; December 2017 (version 4.0.5) | Interactive, web-based aid | Available online | Personalized lung cancer risk estimates for patients that: Collects patients’ risk factors data; Shows lung cancer risks and eligibility; Compares options of LDCT scans and smoking cessation; Instructs patients and clinicians to make decisions as appropriate |
The effectiveness of the DA has not been evaluated |
| Decision Aid for Lung Cancer Screening with Computerized Tomography (CT) (https://www.thoracic.org/patients/patient-resources/resources/decision-aid-lcs.pdf); American Thoracic Society Thoracic Oncology Assembly; June 2015 | Brochure | Available online | Lung cancer and screening information | The effectiveness of the DA has not been evaluated |
| Copies available for order | Smoking cessation information | |||
| Screening choices | ||||
| Benefits and harms of LCS | ||||
| Value clarification | ||||
| Deliberation to healthcare provider | ||||
| Printable Shared Decision-Making Aids (https://www.emmc.org/Lung-Cancer-Screening/Printable-Shared-Decision-Making-Aids.aspx); Eastern Maine Medical Center; 2015 | Web-based aid | Available online | Estimates for individual risk of lung cancer for current or former smokers | The effectiveness of the DA has not been evaluated |
| Benefits and potential risks of LCS | ||||
| Lung Cancer Screening Decision Tool (http://nomograms.mskcc.org/Lung/Screening.aspx); Peter Bach, Memorial Sloan Kettering Medical Center; June 2013 | Web-based prediction tool | Available online | Online questionnaire that asks about lung cancer risk factors (e.g., age and smoking history, occupational exposure to asbestos) | Estimates are calculated from 2 models: one predicts the chance that a person will die of lung cancer in a year, and the other yields the chance that a person will die of another cause (53) |
| Results help clinicians and patients determine the chance that screening will be beneficial | The former model has been validated | |||
| The latter model was found to be undercalibrated for the frequency of deaths from other causes. However, recalibration did not alter the estimates to a meaningful degree |
DA, decision aid; LDCT, low-dose computed tomography; LCS, lung cancer screening.