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• W2896862331 abstract "Screening with low-dose CT scan has been shown to reduce mortality from lung cancer in those at risk based on age and smoking history. While lung cancer screening (LCS) is recommended by the United States Preventative Services Task Force and many professional societies, it has been recognized that the decision to be screened is complex due to a close balance of risk and benefit; therefore, shared decision-making is considered an essential component of effective LCS. The Centers for Medicare and Medicaid Services provides coverage for LCS following a mandated shared-decision making (SDM) visit. Here we review the concept of SDM, facilitators and barriers, evidence and knowledge gaps, and novel considerations for SDM within LCS. Screening with low-dose CT scan has been shown to reduce mortality from lung cancer in those at risk based on age and smoking history. While lung cancer screening (LCS) is recommended by the United States Preventative Services Task Force and many professional societies, it has been recognized that the decision to be screened is complex due to a close balance of risk and benefit; therefore, shared decision-making is considered an essential component of effective LCS. The Centers for Medicare and Medicaid Services provides coverage for LCS following a mandated shared-decision making (SDM) visit. Here we review the concept of SDM, facilitators and barriers, evidence and knowledge gaps, and novel considerations for SDM within LCS. FOR RELATED CORRESPONDENCE, SEE PAGE 236Health-care decisions, especially those concerning cancer screening, are increasingly complex for patients. Previously, the Benjamin Franklin adage that “An ounce of prevention is worth a pound of cure” drove subscription to screening tests as evidenced by one survey in which most US adults opted for a full-body CT scan instead of $1,000.1Schwartz L.M. Woloshin S. Fowler Jr., F.J. Welch H.G. Enthusiasm for cancer screening in the United States.JAMA. 2004; 291: 71-78Crossref PubMed Scopus (541) Google Scholar There has been a paradigm shift, however, with an increased recognition that some cancer screening tests are “preference sensitive.” The closely balanced risks and benefits of these tests make the decision partly reliant on strongly held patient values and preferences. Lung cancer screening (LCS) with annual low-dose CT is the newest in guideline-recommended cancer screening by the US Preventive Task Force and other professional societies with a strong emphasis on the process of shared decision-making (SDM).2Mazzone P. Powell C.A. Arenberg D. et al.Components necessary for high-quality lung cancer screening: American College of Chest Physicians and American Thoracic Society Policy Statement.Chest. 2015; 147: 295-303Abstract Full Text Full Text PDF PubMed Scopus (152) Google Scholar, 3Moyer V.A. USPST Force Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement.Ann Intern Med. 2014; 160: 330-338Crossref PubMed Google Scholar, 4Mazzone P.J. Silvestri G.A. Patel S. et al.Screening for Lung Cancer: CHEST Guideline and Expert Panel Report.Chest. 2018; 153: 954-985Abstract Full Text Full Text PDF PubMed Scopus (191) Google Scholar Further, the Center for Medicare and Medicaid Services has tied reimbursement for LCS to a required “lung cancer screening counseling and shared decision-making visit,”5Centers for Medicare & Medicaid Services Decision memo for screening for lung cancer with low dose computed tomography (LDCT).2015https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=274Google Scholar a first for any screening test. FOR RELATED CORRESPONDENCE, SEE PAGE 236 From both a practical implementation and research standpoint, there are questions that need to be answered including: What exactly is encompassed in an SDM visit? What is the evidence to support its use in LCS? What are facilitators and barriers to conducting such a visit? There is an emerging body of literature that begins to shed light on these, although several gaps remain. To begin, a proper definition of SDM is important; it is a collaborative process between health-care providers and patients allowing decisions to be made together while incorporating the available evidence on the potential harms and benefits of the test with pertinent patients values and preferences.6Elwyn G. Frosch D. Thomson R. et al.Shared decision making: a model for clinical practice.J Gen Intern Med. 2012; 27: 1361-1367Crossref PubMed Scopus (2049) Google Scholar SDM interventions are developed with the goal of facilitating this approach by striving to elicit and support patient values and preferences instead of increasing screening uptake. Interventions can include tools such as decision aids that serve to deliver balanced information to improve patient knowledge on potential benefits and harms, clarify their personal values, and participate in decisions consistent with these values. If SDM is successful, it matters not if the patient has accepted or declined screening as long as the decision was in line with his or her individual values and goals of care. Although the concept of SDM makes sense, it is not always readily accepted by clinicians. For example, in one study assessing whether clinical teams would direct patients to the use of a web-based decision aid, low uptake was found to be a result of clinicians poor understanding of tool utility, their strong belief that SDM was already happening, and their belief that patients are resistant to being involved in treatment decisions.7Elwyn G. Rix A. Holt T. Jones D. Why do clinicians not refer patients to online decision support tools? Interviews with front line clinics in the NHS.BMJ Open. 2012; 2Crossref PubMed Scopus (29) Google Scholar As it relates to screening tests, most patients identified their physician as the primary source of information; however, they also noted that their preferences were rarely elicited and that the pros of screening were most always addressed with little mention of the harms. In one national study, providers discussed the pros of screening 90% of the time but only discussed the downsides 19% of the time in breast cancer screening and 30% of the time in prostate cancer screening.8Hoffman R.M. Lewis C.L. Pignone M.P. et al.Decision-making processes for breast, colorectal, and prostate cancer screening: the DECISIONS survey.Med Decis Making. 2010; 30: 53S-64SCrossref PubMed Scopus (151) Google Scholar Further, two separate systematic reviews have demonstrated patients overestimate the benefits of an intervention and underestimate the harm, whereas clinicians had similar inaccurate expectations of benefits and harms.9Hoffmann T.C. Del Mar C. Patients' expectations of the benefits and harms of treatments, screening, and tests: a systematic review.JAMA Intern Med. 2015; 175: 274-286Crossref PubMed Scopus (352) Google Scholar, 10Hoffmann T.C. Del Mar C. Clinicians' expectations of the benefits and harms of treatments, screening, and tests: a systematic review.JAMA Intern Med. 2017; 177: 407-419Crossref PubMed Scopus (265) Google Scholar Taken together, if both parties believe incorrectly that the benefits are great and the harms small, then health-care management decisions are likely to be poor. What then constitutes a remedy? Education on both sides is paramount. Although patients vary in the level of involvement they would like to have, eliciting the degree to which they would like to participate is helpful in framing discussions. Practitioners must recognize the steady movement away from paternalistic approaches to medical decision-making and focus on involving patients in the process. It may be, as some have suggested, that the design of research that relies on investigators and systematic reviews to influence change in clinical practice is too slow a process.11Hoffmann T. Straus S. Sharing knowledge for health care.JAMA Intern Med. 2017; 177: 1243-1244Crossref PubMed Scopus (5) Google Scholar The suggested solution is that patient-centered research be conducted and that standardized ways to optimize trial reporting are made available to allow the details of interventions to be more easily replicable.11Hoffmann T. Straus S. Sharing knowledge for health care.JAMA Intern Med. 2017; 177: 1243-1244Crossref PubMed Scopus (5) Google Scholar Similarly, patients must be provided with a balanced and comprehensible view of potential health-care options and associated risks and benefits in a format they can understand. There is a cadre of literature to support the use of decision aids that both improve patient knowledge and understanding and increase consistency between patient choices and values.12Stacey D. Legare F. Col N.F. et al.Decision aids for people facing health treatment or screening decisions.Cochrane Database Syst Rev. 2014; : CD001431PubMed Google Scholar Decision aids can be paper, video, web-based, or multimedia. Within the context of LCS, there have been several studies demonstrating that SDM using a variety of decision aids improves knowledge.13Mazzone P.J. Tenenbaum A. Seeley M. et al.Impact of a lung cancer screening counseling and shared decision-making visit.Chest. 2017; 151: 572-578Abstract Full Text Full Text PDF PubMed Scopus (69) Google Scholar, 14Lau Y.K. Caverly T.J. Cao P. et al.Evaluation of a personalized, web-based decision aid for lung cancer screening.Am J Prev Med. 2015; 49: e125-e129Abstract Full Text Full Text PDF PubMed Scopus (58) Google Scholar Unfortunately, studies within LCS have also shown that the use of SDM and decision aids has been suboptimal.15Wiener R.S. Koppelman E. Bolton R. et al.Patient and clinician perspectives on shared decision-making in early adopting lung cancer screening programs: a qualitative study.J Gen Intern Med. 2018; 33: 1035-1042Crossref PubMed Scopus (61) Google Scholar, 16Kanodra N.M. Pope C. Halbert C.H. Silvestri G.A. Rice L.J. Tanner N.T. Primary care provider and patient perspectives on lung cancer screening. a qualitative study.Ann Am Thorac Soc. 2016; 13: 1977-1982Crossref PubMed Scopus (84) Google Scholar Although many patients find decision aids helpful,15Wiener R.S. Koppelman E. Bolton R. et al.Patient and clinician perspectives on shared decision-making in early adopting lung cancer screening programs: a qualitative study.J Gen Intern Med. 2018; 33: 1035-1042Crossref PubMed Scopus (61) Google Scholar, 16Kanodra N.M. Pope C. Halbert C.H. Silvestri G.A. Rice L.J. Tanner N.T. Primary care provider and patient perspectives on lung cancer screening. a qualitative study.Ann Am Thorac Soc. 2016; 13: 1977-1982Crossref PubMed Scopus (84) Google Scholar one evaluation of SDM for LCS found that clinicians varied in the information shared with patients and inconsistently incorporated decisions aids.15Wiener R.S. Koppelman E. Bolton R. et al.Patient and clinician perspectives on shared decision-making in early adopting lung cancer screening programs: a qualitative study.J Gen Intern Med. 2018; 33: 1035-1042Crossref PubMed Scopus (61) Google Scholar Further, patient accounts suggested that conversations about LCS did meet the aforementioned definition of a SDM encounter; however, a counseling session conducted by a dedicated nurse screening coordinator resulted in more thorough discussions and is an approach favored by clinicians to free up their time.15Wiener R.S. Koppelman E. Bolton R. et al.Patient and clinician perspectives on shared decision-making in early adopting lung cancer screening programs: a qualitative study.J Gen Intern Med. 2018; 33: 1035-1042Crossref PubMed Scopus (61) Google Scholar, 16Kanodra N.M. Pope C. Halbert C.H. Silvestri G.A. Rice L.J. Tanner N.T. Primary care provider and patient perspectives on lung cancer screening. a qualitative study.Ann Am Thorac Soc. 2016; 13: 1977-1982Crossref PubMed Scopus (84) Google Scholar Another recent study evaluating the quality of the conversations around LCS found that none met criteria for true SDM.17Brenner A.T. Malo T.L. Margolis M. et al.Evaluating shared decision making for lung cancer screening.JAMA Intern Med. 2018; 178: 1311-1316Crossref PubMed Scopus (113) Google Scholar In addition, all physicians included in this qualitative study recommended LCS with very minimal mention of its potential harms. The average time spent discussing LCS was less than a minute (8% of total visit time), with no reference to decision aids or education materials.17Brenner A.T. Malo T.L. Margolis M. et al.Evaluating shared decision making for lung cancer screening.JAMA Intern Med. 2018; 178: 1311-1316Crossref PubMed Scopus (113) Google Scholar This supports previously noted barriers to SDM within LCS including familiarity with guidelines and time constraints of clinic visits.16Kanodra N.M. Pope C. Halbert C.H. Silvestri G.A. Rice L.J. Tanner N.T. Primary care provider and patient perspectives on lung cancer screening. a qualitative study.Ann Am Thorac Soc. 2016; 13: 1977-1982Crossref PubMed Scopus (84) Google Scholar The findings are in stark contrast, however, to one editorial suggesting that one of the reasons for low uptake of LCS is that the benefits are understated and the harms overstated when using decision aids during the shared decision counseling visit.18Yankelevitz D.F. CT Screening for lung cancer: successful trial, but failed understanding.J Thorac Oncol. 2018; 13: 12-15Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar It is unclear whether primary care providers understand or have time to review the nuances of LCS, including eligibility, benefits, potential harms, and smoking cessation counseling.16Kanodra N.M. Pope C. Halbert C.H. Silvestri G.A. Rice L.J. Tanner N.T. Primary care provider and patient perspectives on lung cancer screening. a qualitative study.Ann Am Thorac Soc. 2016; 13: 1977-1982Crossref PubMed Scopus (84) Google Scholar This is may be one of many factors contributing to poor screening uptake among high-risk current and former smokers in the United States. In fact, <4% of eligible patients in the United States were screened for lung cancer in 2015 and an even lower number of screening was estimated for 2017.19Jemal A. Fedewa S.A. Lung cancer screening with low-dose computed tomography in the United States-2010 to 2015.JAMA Oncol. 2017; 3: 1278-1281Crossref PubMed Scopus (344) Google Scholar, 20Green A.K. Bach P. Model-based eligibility for lung cancer screening: where theory meets practice.Ann Intern Med. 2018; 168: 223-224Crossref PubMed Scopus (7) Google Scholar To improve both the number of patients being screened and the quality of SDM visit, novel approaches for patient outreach should be considered. This issue of CHEST includes a short report on decision impact and quality following SDM for LCS in two separate settings: over the telephone and in person.21Tanner N.T. Banas E. Yeager D. Dai L. Hughes Halbert C. Silvestri G.A. In-person and telephonic shared decision-making visits for people considering lung cancer screening: an assessment of decision quality.Chest. 2019; 155: 236-238Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar Participants were highly satisfied and had little conflict with their LCS decision, regardless of whether SDM was completed in person or by telephone. Each intervention was effective based on high satisfaction scores suggesting good decisional impact and low decisional regret suggesting good decisional quality. Although the majority (88%) went on to accept screening, those that declined were just as satisfied with their decision and had little regret. The findings suggest that patients made an informed decision that was concordant with their values and further supports SDM for LCS by varying modalities will result in high-quality decisional outcomes. Other research has shown that similar telehealth visits are as effective as clinic-based, in-person counseling visits for diseases such as posttraumatic stress disorder.22Acierno R. Gros D.F. Ruggiero K.J. et al.Behavioral activation and therapeutic exposure for posttraumatic stress disorder: a noninferiority trial of treatment delivered in person versus home-based telehealth.Depress Anxiety. 2016; 33: 415-423Crossref PubMed Scopus (103) Google Scholar Conducting SDM over the telephone has the potential to improve logistics and convenience for patients. It allows more time to be spent discussing personal lung cancer risk and pros and cons of screening without the pressure of addressing other medical issues, as is often the case during routine outpatient visits. Studies have recognized that smokers have known barriers to LCS including fatalistic beliefs, a distrust in the medical system, denial of risk, and fear of screening.23Gressard L. DeGroff A.S. Richards T.B. et al.A qualitative analysis of smokers' perceptions about lung cancer screening.BMC Public Health. 2017; 17: 589Crossref PubMed Scopus (25) Google Scholar, 24Jonnalagadda S. Bergamo C. Lin J.J. et al.Beliefs and attitudes about lung cancer screening among smokers.Lung Cancer. 2012; 77: 526-531Abstract Full Text Full Text PDF PubMed Scopus (108) Google Scholar They are a hard to reach and a generally less educated population that is less likely to identify a primary care provider, making telehealth appealing.25Silvestri G.A. Nietert P.J. Zoller J. Carter C. Bradford D. Attitudes towards screening for lung cancer among smokers and their non-smoking counterparts.Thorax. 2007; 62: 126-130Crossref PubMed Scopus (141) Google Scholar For patients who reside far from screening services, this has the potential to provide access to providers specializing in all aspects of LCS and management of screen-detected findings. It is conceivable that a hybrid LCS screening program in which centers of excellence partner with rural or underserved areas could use this telephonic approach to SDM to educate eligible patients and increase screening uptake. For example, an eligible patient may be referred by a rural primary care provider or health fair to undergo a telephone SDM visit and then undergo the low-dose CT locally, with suspicious findings on CT being digitally transferred to the center of excellence for multidisciplinary review and management. One qualitative study identified perceived low value as a reason for opting out of LCS.26Carter-Harris L. Brandzel S. Wernli K.J. Roth J.A. Buist D.S.M. A qualitative study exploring why individuals opt out of lung cancer screening.Family Practice. 2017; 34: 239-244PubMed Google Scholar In the study reported in this issue, three-quarters of participants were in the highest risk category (average risk = 5.2%) for developing lung cancer as calculated by the PLCOm2012 model. This risk was communicated with patients as part of the SDM visit, and it may be that participants perceived the test to be of high value after weighing the risks and benefits. There has been some published commentary suggesting that timing of SDM visit may influence patient acceptance; for example, once a patient has come in for an SDM visit he or she has already made the decision to be screened.27Dobler C.C. Midthun D.E. Montori V.M. Quality of shared decision making in lung cancer screening: the right process, with the right partners, at the right time and place.Mayo Clin Proceedings. 2017; 92: 1612-1616Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar In the study reported here, however, those in the telephonic cohort made no additional effort other than to answer the phone; the acceptance rate was equally as high as those who came in for the in-person SDM visit. Other studies have identified cost as a reason for patients to be less likely to consider lung screening24Jonnalagadda S. Bergamo C. Lin J.J. et al.Beliefs and attitudes about lung cancer screening among smokers.Lung Cancer. 2012; 77: 526-531Abstract Full Text Full Text PDF PubMed Scopus (108) Google Scholar; it may be that the low cost to the telephone SDM cohort (veterans) contributed to high acceptance. Although the in-person cohort did indicate cost as a potential barrier to screening, it did not affect acceptance. As LCS continues to be implemented in the United States, SDM should be viewed not as a nuisance or an obligatory check box for reimbursement, but as a way to engage in patient-centered care. It also presents an opportunity to discuss tobacco cessation and deliver tobacco treatment with the potential to improve both lung cancer–specific and all-cause mortality. Prior work has demonstrated 7 years of smoking abstinence results in the same 20% mortality reduction seen in the screening arm of the National Lung Screening Test with an even greater mortality reduction achieved when screening and cessation are achieved.28Tanner N.T. Kanodra N.M. Gebregziabher M. et al.The association between smoking abstinence and mortality in the National Lung Screening Trial.Am J Respir Crit Care Med. 2016; 193: 534-541Crossref PubMed Scopus (127) Google Scholar Although the delivery of balanced information to the patient is a huge first step in SDM and is arguably an improvement to current practice, the next and equally important step is patient preference clarification. This key component of SDM serves to help patients consider how they value key elements of the decision they are facing. It brings the focus to the attributes of the test (eg, early detection of cancer, false-positive results), whole entities (eg, undergoing screening or not), and the context of the decision (eg, individual risk, the doctor’s opinion, family opinion).29Fagerlin A. Pignone M. Abhyankar P. et al.Clarifying values: an updated review.BMC Med Inform Decis Mak. 2013; 13: S8Crossref PubMed Scopus (163) Google Scholar It involves encouragement of communication of patient values. There are a variety of values clarification methods built into available decision aids for LCS with the intent on facilitating the discussion. Unfortunately, few providers are trained in the nuances of SDM and it is not currently part of most medical school curriculum. If knowledge and time constraints pose a barrier to SDM, a feasible option is to consider the training of decision counselors for LCS. Some screening programs use nurse navigators and advanced practice providers to lead LCS programs, conduct SDM, and incorporate smoking cessation counseling into a comprehensive screening visit. This model stands to benefit our patients by providing adequate time and a standardized approach to the components needed for high-quality LCS. In the end, SDM is one of the foundational elements of the doctor–patient relationship and, in regard to LCS, that critical conversation is just beginning. Financial/nonfinancial disclosure: The authors have reported to CHEST the following: N. T. T. receives grant support from the American Cancer Society. None declared (G. A. S.). In-person and Telephonic Shared Decision-making Visits for People Considering Lung Cancer Screening: An Assessment of Decision QualityCHESTVol. 155Issue 1PreviewThe decision to undergo lung cancer screening (LCS) is complex, and a shared decision-making (SDM) visit is essential. Although the Centers for Medicare & Medicaid Services requires an in-person visit, this approach may not be feasible for certain providers and patients due to constrained resources and logistical considerations.1 We undertook the present study to determine the effect of an SDM visit delivered by two different methods on patient satisfaction and decisional conflict. 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• W2896862331 title "Shared Decision-making and Lung Cancer Screening" @default.
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• W2896862331 cites W2096781108 @default.
• W2896862331 cites W2103523794 @default.
• W2896862331 cites W2139277921 @default.
• W2896862331 cites W2161362572 @default.
• W2896862331 cites W2180734158 @default.
• W2896862331 cites W2290962969 @default.
• W2896862331 cites W2524781933 @default.
• W2896862331 cites W2548502420 @default.
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• W2896862331 cites W2737313243 @default.
• W2896862331 cites W2766953743 @default.
• W2896862331 cites W2770527777 @default.
• W2896862331 cites W2782293370 @default.
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