College of Social Work, University of South Carolina, 1514 Pendleton Street, Columbia, SC, USA.
College of Nursing, University of South Carolina, Columbia, SC, USA.
Cancer Causes Control. 2023 Mar;34(3):287-294. doi: 10.1007/s10552-022-01650-2. Epub 2022 Nov 11.
To reduce lung cancer mortality, individuals at high-risk should receive a low-dose computed tomography screening annually. To increase the likelihood of screening, interventions that promote shared decision-making are needed. The goal of this study was to investigate the feasibility, acceptability, usability, and preliminary effectiveness of a computer-based decision aid.
Thirty-three participants were recruited through primary-care clinics in a small southeastern-US city. Participants used a computer-based decision aid ("Is Lung Cancer Screening for You?") during a clinic appointment. Paper surveys collected self-reported feasibility, acceptability, and usability data. A research coordinator was present to observe each patient's and health-care provider's interactions, and to assess the fidelity of shared decision-making.
The decision aid was feasible, acceptable for use in a clinic setting, and easy for participants to use. Patients had low decisional conflict following use of the decision aid and had high screening intention and actual screening rates. Shared decision-making discussions using the decision aid were nearly 6 min on average.
Computer-based decision aids are feasible for promoting shared lung cancer-screening decisions. A more robust study is warranted to measure the added value of a computer-based version of this aid versus a paper-based aid.
为降低肺癌死亡率，高危个体应每年接受低剂量计算机断层扫描筛查。为提高筛查的可能性，需要采取促进共同决策的干预措施。本研究旨在调查一种基于计算机的决策辅助工具的可行性、可接受性、可用性和初步效果。
通过美国东南部一个小城市的初级保健诊所招募了 33 名参与者。参与者在诊所预约期间使用基于计算机的决策辅助工具（“肺癌筛查适合你吗？”）。纸质调查问卷收集了自我报告的可行性、可接受性和可用性数据。研究协调员在场观察每位患者和医疗保健提供者的互动，并评估共同决策的保真度。
决策辅助工具具有可行性，在诊所环境中使用是可以接受的，而且参与者易于使用。使用决策辅助工具后，患者的决策冲突较低，筛查意愿和实际筛查率较高。使用决策辅助工具进行的共同决策讨论平均时长约为 6 分钟。
基于计算机的决策辅助工具可用于促进共同的肺癌筛查决策。需要进行更强大的研究来衡量这种基于计算机的辅助工具相对于纸质辅助工具的附加价值。
