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Effects of Personalized Risk Information on Patients Referred for Lung Cancer Screening with Low-Dose CT

Author

Listed:
  • Paul K. J. Han

    (Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA)

  • Christine Lary

    (Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA)

  • Adam Black

    (Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA)

  • Caitlin Gutheil

    (Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA)

  • Hayley Mandeville

    (Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA)

  • Jason Yahwak

    (Chest Medicine Associates, Portland, ME, USA)

  • Mayuko Fukunaga

    (Department of Population Health Sciences, University of Massachusetts, Worcester, MA, USA)

Abstract

Background. Low-dose computed tomography (LDCT) screening for lung cancer is a preference-sensitive intervention that should ideally be individualized according to patients’ likelihood of benefit and personal values. Personalized cancer risk information (PCRI) may facilitate this goal, but its effects are unknown. Objective. To evaluate the effects of providing PCRI to patients referred for LDCT screening. Design. Mixed-methods, pre-post study using surveys administered to patients before and after provision of PCRI—calculated by the PLCOm2012 risk prediction model—in shared decision-making consultations, and postvisit qualitative interviews. Setting. Centralized specialty-based LDCT screening program at a tertiary care hospital. Participants. Convenience sample of eligible patients referred for LDCT screening. Measurements. Pre- and postvisit surveys assessed patients’ 1) perceived lung cancer risk, 2) uncertainty about their risk, 3) minimum risk threshold for wanting screening, 4) interest in LDCT screening, and 5) interest in smoking cessation. Qualitative interviews explored patients’ perceptions of the value of PCRI. Screening uptake was assessed by chart review. Results. Sixty of 70 (86%) patients received PCRI and completed pre-post surveys, and 17 patients (28%) completed qualitative interviews. Perceived lung cancer risk decreased from 52% previsit to 31% postvisit ( P

Suggested Citation

  • Paul K. J. Han & Christine Lary & Adam Black & Caitlin Gutheil & Hayley Mandeville & Jason Yahwak & Mayuko Fukunaga, 2019. "Effects of Personalized Risk Information on Patients Referred for Lung Cancer Screening with Low-Dose CT," Medical Decision Making, , vol. 39(8), pages 950-961, November.
    • Handle: RePEc:sae:medema:v:39:y:2019:i:8:p:950-961
    DOI: 10.1177/0272989X19875966
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    Cited by:

    1. Erika A. Waters & Jennifer M. Taber & Nicole Ackermann & Julia Maki & Amy M. McQueen & Laura D. Scherer, 2023. "Testing Explanations for Skepticism of Personalized Risk Information," Medical Decision Making, , vol. 43(4), pages 430-444, May.
    2. Tammy C. Hoffmann & Mina Bakhit & Marie-Anne Durand & Lilisbeth Perestelo-Pérez & Catherine Saunders & Juan P. Brito, 2021. "Basing Information on Comprehensive, Critically Appraised, and Up-to-Date Syntheses of the Scientific Evidence: An Update from the International Patient Decision Aid Standards," Medical Decision Making, , vol. 41(7), pages 755-767, October.
    3. Lyndal J. Trevena & Carissa Bonner & Yasmina Okan & Ellen Peters & Wolfgang Gaissmaier & Paul K. J. Han & Elissa Ozanne & Danielle Timmermans & Brian J. Zikmund-Fisher, 2021. "Current Challenges When Using Numbers in Patient Decision Aids: Advanced Concepts," Medical Decision Making, , vol. 41(7), pages 834-847, October.

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