共同决策与肺癌筛查：让我们开启对话。
Shared Decision-making and Lung Cancer Screening: Let's Get the Conversation Started.
机构信息
Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Veterans Affairs Hospital, Charleston, SC; Department of Medicine, Thoracic Oncology Research Group, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, SC.
Department of Medicine, Thoracic Oncology Research Group, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, SC.
出版信息
Chest. 2019 Jan;155(1):21-24. doi: 10.1016/j.chest.2018.10.013. Epub 2018 Oct 22.
Screening with low-dose CT scan has been shown to reduce mortality from lung cancer in those at risk based on age and smoking history. While lung cancer screening (LCS) is recommended by the United States Preventative Services Task Force and many professional societies, it has been recognized that the decision to be screened is complex due to a close balance of risk and benefit; therefore, shared decision-making is considered an essential component of effective LCS. The Centers for Medicare and Medicaid Services provides coverage for LCS following a mandated shared-decision making (SDM) visit. Here we review the concept of SDM, facilitators and barriers, evidence and knowledge gaps, and novel considerations for SDM within LCS.
低剂量 CT 扫描筛查已被证明可以降低有风险的人群（根据年龄和吸烟史）的肺癌死亡率。虽然美国预防服务工作组和许多专业协会都推荐进行肺癌筛查（LCS），但人们已经认识到，由于风险和收益之间的平衡非常接近，因此筛查决策非常复杂；因此，共同决策被认为是有效 LCS 的一个重要组成部分。医疗保险和医疗补助服务中心（Centers for Medicare and Medicaid Services）在经过强制性共同决策（SDM）访问后，为 LCS 提供了覆盖范围。在这里，我们回顾了 SDM 的概念、促进因素和障碍、证据和知识空白，以及 LCS 中 SDM 的新考虑因素。
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