The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Cancer. 2024 Dec 1;130(23):3996-4011. doi: 10.1002/cncr.35382. Epub 2024 Sep 20.
Shared decision making (SDM) between health care professionals and patients is essential to help patients make well informed choices about lung cancer screening (LCS). Patients who participate in SDM have greater LCS knowledge, reduced decisional conflict, and improved adherence to annual screening compared with patients who do not participate in SDM. SDM tools are acceptable to patients and clinicians. The importance of SDM in LCS is emphasized in recommendations from professional organizations and highlighted as a priority in the 2022 President's Cancer Panel Report. The updated 2022 national coverage determination from the Centers for Medicare & Medicaid Services reaffirms the value of SDM in offering LCS to eligible beneficiaries. The Shared Decision-Making Task Group of the American Cancer Society National Lung Cancer Roundtable undertook a group consensus process to identify priorities for research and implementation related to SDM for LCS and then evaluated current knowledge in these areas. Priority areas included: (1) developing feasible, adaptable SDM training programs for health care professionals; (2) understanding the impact of alternative health system LCS models on SDM practice and outcomes; (3) developing and evaluating new patient decision aids for use with diverse populations and in varied settings; (4) offering conceptual clarity about what constitutes a high-quality decision and developing appropriate quality measures; and (5) studying the use of prediction-augmented screening to support SDM in practice. Gaps in current research in all areas were observed. The authors conclude with a research and implementation agenda to advance the quality and implementation of SDM for persons who might benefit from LCS.
在帮助患者做出明智的肺癌筛查(LCS)选择方面,医疗保健专业人员与患者之间的共同决策(SDM)至关重要。与未参与 SDM 的患者相比,参与 SDM 的患者对 LCS 的了解更多,决策冲突减少,并且对年度筛查的依从性更高。SDM 工具可被患者和临床医生接受。专业组织的建议强调了 SDM 在 LCS 中的重要性,并将其作为 2022 年总统癌症小组报告的优先事项之一。医疗保险和医疗补助服务中心(Centers for Medicare & Medicaid Services)的最新 2022 年国家覆盖范围决定重申了 SDM 在向符合条件的受益人提供 LCS 方面的价值。美国癌症协会国家肺癌圆桌会议的 SDM 任务组进行了小组共识过程,以确定与 LCS 的 SDM 相关的研究和实施的优先事项,然后评估了这些领域的现有知识。优先领域包括:(1)为医疗保健专业人员开发可行、可适应的 SDM 培训计划;(2)了解替代的 LCS 模型对 SDM 实践和结果的影响;(3)为不同人群和不同环境开发和评估新的患者决策辅助工具;(4)提供有关构成高质量决策的概念清晰度,并制定适当的质量措施;(5)研究使用预测增强筛查来支持实践中的 SDM。观察到所有领域的当前研究都存在差距。作者最后提出了一项研究和实施议程,以提高可能受益于 LCS 的人群的 SDM 的质量和实施。