Impact of a Lung Cancer Screening Counseling and Shared Decision-Making Visit.
BACKGROUND
Lung cancer screening is a complex balance of benefits and harms. A counseling and shared decision-making visit has been mandated to assist patients with the decision about participation in screening. To our knowledge, the impact of this visit on patient understanding and decisions has not been studied.


METHODS
We developed a centralized counseling and shared decision-making visit for our lung cancer screening program. The visit included confirmation of eligibility for screening, education supported by a narrated slide show, individualized risk assessment with a decision aid, time for answering questions, and data collection. We surveyed consecutive patients prior to the visit, immediately after the visit, and 1 month after the visit to determine the impact of the visit on their knowledge.


RESULTS
Twenty-three of 423 patients (5.4%) who had a visit did not proceed to the screening CT scan. One hundred twenty-five consecutive patients completed the initial survey, 122 completed the postvisit survey, and 113 completed the 1-month follow-up survey. Prior to the visit, the patients had a poor level of understanding about the age and smoking eligibility criteria (8.8% and 13.6% correct, respectively) and the benefits and harms of screening (55.2% and 38.4% correct, respectively). There was a significant improvement in knowledge noted after the visit for all questions (P = .03 to P < .0001). Knowledge waned by the 1-month follow-up but remained higher than it was before the visit.


CONCLUSIONS
A centralized counseling and shared decision-making visit impacts the patient's knowledge about the eligibility criteria, benefits, and harms of lung cancer screening with LDCT, helping patients make value-based decisions.
['Mazzone|Peter J|PJ|', 'Tenenbaum|Amanda|A|', 'Seeley|Meredith|M|', 'Petersen|Hilary|H|', 'Lyon|Christina|C|', 'Han|Xiaozhen|X|', 'Wang|Xiao-Feng|XF|']
D000367:Age Factors D000368:Aged D003376:Counseling D003657:Decision Making D003661:Decision Support Techniques D055088:Early Detection of Cancer D004608:Eligibility Determination D005260:Female D007722:Health Knowledge, Attitudes, Practice D006801:Humans D008175:Lung Neoplasms D008297:Male D008875:Middle Aged D010353:Patient Education as Topic D018570:Risk Assessment D012907:Smoking D014057:Tomography, X-Ray Computed
lung cancer screening shared decision making