Volk Robert J, Linder Suzanne K, Leal Viola B, Rabius Vance, Cinciripini Paul M, Kamath Geetanjali R, Munden Reginald F, Bevers Therese B
Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
Prev Med. 2014 May;62:60-3. doi: 10.1016/j.ypmed.2014.02.006. Epub 2014 Feb 8.
New clinical guidelines endorse the use of low-dose computed tomography (LDCT) for lung cancer screening among selected heavy smokers while recommending patients be counseled about the potential benefits and harms. We developed and field tested a brief, video-based patient decision aid about lung cancer screening.
Smokers in a cancer center tobacco treatment program aged 45 to 75 years viewed the video online between November 2011 and September 2012. Acceptability, knowledge, and clarity of values related to the decision were assessed.
Fifty-two patients completed the study (mean age=58.5 years; mean duration smoking=34.8 years). Acceptability of the aid was high. Most patients (78.8%) indicated greater interest in screening after viewing the aid. Knowledge about lung cancer screening increased significantly as a result of viewing the aid (25.5% of questions answered correctly before the aid, and 74.8% after; P<.01) although understanding of screening eligibility remained poor. Patients reported being clear about which benefits and harms of screening mattered most to them (94.1% and 86.5%, respectively).
Patients have high information needs related to lung cancer screening. A video-based decision aid may be helpful in promoting informed decision-making, but its impact on lung cancer screening decisions needs to be explored.
新的临床指南支持在特定重度吸烟者中使用低剂量计算机断层扫描（LDCT）进行肺癌筛查，同时建议对患者进行关于潜在益处和危害的咨询。我们开发并实地测试了一个简短的、基于视频的肺癌筛查患者决策辅助工具。
2011年11月至2012年9月期间，癌症中心烟草治疗项目中年龄在45至75岁的吸烟者在线观看了该视频。评估了与该决策相关的可接受性、知识和价值观的清晰度。
52名患者完成了研究（平均年龄=58.5岁；平均吸烟时长=34.8年）。该辅助工具的可接受性很高。大多数患者（78.8%）表示在观看辅助工具后对筛查更感兴趣。观看辅助工具后，关于肺癌筛查的知识显著增加（观看辅助工具前25.5%的问题回答正确，观看后为74.8%；P<.01），尽管对筛查资格的理解仍然较差。患者报告称清楚筛查的哪些益处和危害对他们最重要（分别为94.1%和86.5%）。
患者对肺癌筛查有很高的信息需求。基于视频的决策辅助工具可能有助于促进明智的决策，但需要探索其对肺癌筛查决策的影响。
