0
Original Research |

Impact of a Lung Cancer Screening Counseling and Shared-Decision-Making Visit

Peter J. Mazzone, MD, MPH, FCCP; Amanda Tenenbaum, CNP; Meredith Seeley, BSS; Hilary Petersen, PA; Christina Lyon; Xiaozhen Han, MS; Xiao-Feng Wang, PhD
Author and Funding Information

No conflicts of interest exist for any author related to the content of this manuscript

PJM takes responsibility for the integrity of the data and the accuracy of the data analysis. PJM assumes full responsibility for the integrity of the submission as a whole, from inception to published article.

Respiratory Institute, Cleveland Clinic

Corresponding Author Peter J Mazzone 9500 Euclid Ave, A90 Cleveland, OH 44195.


Copyright 2016, . All Rights Reserved.


Chest. 2016. doi:10.1016/j.chest.2016.10.027
Text Size: A A A
Published online

Abstract

Background  Lung cancer screening is a complex balance of benefit and harms. A counseling and shared decision making visit has been mandated to assist patient’s with the decision about participation in screening. 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 their visit, immediately after their visit, and 1-month after their visit to determine the impact of the visit on their knowledge.

Results  23 of 423 (5.4%) patients who had a visit did not proceed on to the screening CT scan. 125 consecutive patients completed the initial survey, 122 the post-visit survey, and 113 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 benefit 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=0.03 – p<0.0001). Knowledge waned by the 1-month follow-up but remained higher than it was pre-visit.

Conclusions  A centralized counseling and shared decision making visit impacts knowledge of the eligibility criteria, benefit, and harms of lung cancer screening with LDCT, helping patients make value based decisions.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543