Wiener Renda Soylemez, Barker Anna M, Carter-Harris Lisa, Caverly Tanner J, Crocker David A, Denietolis Angela, Doherty Charlotte, Fagerlin Angela, Gallagher-Seaman Mary, Gould Michael K, Han Paul K J, Herbst Abigail N, Ito Fukunaga Mayuko, McCullough Megan B, Miano Danielle A, Quaife Samantha L, Slatore Christopher G, Fix Gemmae M
Am J Respir Crit Care Med. 2022 Mar 15;205(6):619-630. doi: 10.1164/rccm.202201-0126ST.
Shared decision-making (SDM) for lung cancer screening (LCS) is recommended in guidelines and required by Medicare, yet it is seldom achieved in practice. The best approach for implementing SDM for LCS remains unknown, and the 2021 U.S. Preventive Services Task Force calls for implementation research to increase uptake of SDM for LCS. To develop a stakeholder-prioritized research agenda and recommended outcomes to advance implementation of SDM for LCS. The American Thoracic Society and VA Health Services Research and Development Service convened a multistakeholder committee with expertise in SDM, LCS, patient-centered care, and implementation science. During a virtual State of the Art conference, we reviewed evidence and identified research questions to address barriers to implementing SDM for LCS, as well as outcome constructs, which were refined by writing group members. Our committee ( = 34) then ranked research questions and SDM effectiveness outcomes by perceived importance in an online survey. We present our committee's consensus on three topics important to implementing SDM for LCS: ) foundational principles for the best practice of SDM for LCS; ) stakeholder rankings of 22 implementation research questions; and ) recommended outcomes, including Proctor's implementation outcomes and stakeholder rankings of SDM effectiveness outcomes for hybrid implementation-effectiveness studies. Our committee ranked questions that apply innovative implementation approaches to relieve primary care providers of the sole responsibility of SDM for LCS as highest priority. We rated effectiveness constructs that capture the patient experience of SDM as most important. This statement offers a stakeholder-prioritized research agenda and outcomes to advance implementation of SDM for LCS.
肺癌筛查（LCS）的共同决策（SDM）在指南中被推荐且医疗保险要求实施，但在实际中却很少能实现。实施LCS的SDM的最佳方法仍不明确，2021年美国预防服务工作组呼吁开展实施研究以提高LCS的SDM采用率。为制定一个由利益相关者优先排序的研究议程和推荐的结果，以推进LCS的SDM实施。美国胸科学会和退伍军人健康服务研究与发展服务部召集了一个多利益相关者委员会，其成员在SDM、LCS、以患者为中心的护理和实施科学方面具有专业知识。在一次虚拟的最新技术会议期间，我们审查了证据并确定了研究问题，以解决实施LCS的SDM的障碍以及结果构建，这些由写作小组成员进行了完善。然后我们的委员会（n = 34）在一项在线调查中根据感知的重要性对研究问题和SDM有效性结果进行了排名。我们展示了委员会对实施LCS的SDM重要的三个主题的共识：（1）LCS的SDM最佳实践的基本原则；（2）22个实施研究问题的利益相关者排名；（3）推荐的结果，包括普罗克特的实施结果以及混合实施 - 有效性研究的SDM有效性结果的利益相关者排名。我们的委员会将应用创新实施方法以减轻初级保健提供者对LCS的SDM唯一责任的问题列为最高优先级。我们将捕捉患者SDM体验的有效性构建评为最重要。本声明提供了一个由利益相关者优先排序的研究议程和结果，以推进LCS的SDM实施。
