Research Department of Behavioural Science and Health, University College London, London, England.
Research Department of Behavioural Science and Health, University College London, London, England; Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, England.
Chest. 2022 Oct;162(4):930-941. doi: 10.1016/j.chest.2021.12.638. Epub 2021 Dec 16.
Several countries mandate informed or shared decision-making for low-dose CT (LDCT) lung cancer screening, but knowledge is limited about the type of information and presentation techniques used to support decision-making in practice. This review aimed to characterize the content, format, mode, and presentation methods of decision support tools (DSTs) for LDCT lung cancer screening. DSTs reported within peer-reviewed articles (January 2000-April 2021) were identified systematically from PubMed, PsycInfo, EMBASE, and CINAHL Plus. Inclusion criteria revolved around the development or evaluation of a resource or tool intended to support individual or shared decision-making for LDCT lung cancer screening. The data-charting and extraction framework was based on the International Patient Decision Aids Standards instrument and Template for Intervention Description and Reporting. Extracted data were organized within two categories: (1) study characteristics and context, format, and mode of DST use and (2) DST content and presentation methods. This review identified 22 DSTs in paper, video, or electronic formats across 26 articles. Most DSTs (n = 13) focused on knowledge exchange, whereas seven used interactive techniques to support values clarification (eg, Likert scales) and nine DSTs guided deliberation (eg, suggested discussion topics). The DSTs addressed similar topics, but the detail, quantification of probability, and presentation methods varied considerably. None described all the potential screening harms and results. The heterogeneity in DST design may affect the quality of decision-making, particularly for participants with lower literacy and numeracy. Evidence-based consensus guidelines for DST content and presentation methods should be developed collaboratively with screening-eligible adults.
一些国家规定了低剂量 CT（LDCT）肺癌筛查的知情或共同决策，但对于实践中支持决策所使用的信息类型和呈现技术知之甚少。本综述旨在描述 LDCT 肺癌筛查决策支持工具（DST）的内容、格式、模式和呈现方法。从 PubMed、PsycInfo、EMBASE 和 CINAHL Plus 系统地检索了 2000 年 1 月至 2021 年 4 月发表的同行评议文章中报告的 DST。纳入标准围绕旨在支持 LDCT 肺癌筛查个体或共同决策的资源或工具的开发或评估。数据图表和提取框架基于国际患者决策辅助工具标准和干预描述与报告模板。提取的数据组织在两个类别中：（1）研究特征和背景、DST 使用的格式和模式，（2）DST 内容和呈现方法。本综述在 26 篇文章中确定了 22 种以纸质、视频或电子形式呈现的 DST。大多数 DST（n=13）侧重于知识交流，而 7 种使用互动技术来支持价值观澄清（例如，李克特量表），9 种 DST 指导审议（例如，建议的讨论主题）。DST 涉及类似的主题，但详细程度、概率的量化和呈现方法差异很大。没有一个 DST 描述了所有潜在的筛查危害和结果。DST 设计的异质性可能会影响决策的质量，特别是对于文化程度和数学水平较低的参与者。应与有资格接受筛查的成年人合作制定基于证据的 DST 内容和呈现方法共识指南。
