Aiding shared decision making in lung cancer screening: two decision tools.

Abstract

Shared decision making (SDM) preceding lung cancer screening is important for populations that are underrepresented in lung cancer screening trials. Current evidence-based guidelines; however, do not address personal risk and outcomes in underrepresented populations. This study compared two SDM decision aids (Option Grids and Shouldiscreen.com) for SDM efficacy, decision regret and knowledge. We conducted a prospective trial of lung cancer screening patients (N=237) randomized to SDM with Option Grids or Shouldiscreen.com. To evaluate the SDM process after lung cancer screening, patients answered two questionnaires: CollaboRATE and Decision Regret. Patients also completed a questionnaire to test their knowledge of lung cancer screening. Patients were predominantly African American (61.6%), though multiple races, varying education levels and equal genders were represented. Patients in both Option Grids and Shouldiscreen.com groups reported favorable SDM experiences (P=0.60) and equivalent knowledge about lung cancer screening (P=0.43). Patients using Shouldiscreen.com had less knowledge regarding the potential complications of subsequent testing (P=0.02). Shouldiscreen.com patients had increased regret regarding their decision to pursue screening (P=0.02). Option Grids and Shouldiscreen.com both facilitated a meaningful SDM process. However, Option Grids patients experienced decreased decision regret and enhanced knowledge of the potential complications of screening.