肺癌筛查患者决策辅助工具的质量:一项环境扫描的结果

The quality of patient decision aids for lung cancer screening: Results from an environmental scan.

作者信息

Volk Robert J, Lettieri Jessica S, Leal Viola B, Duhon Gabrielle F, Maki Kristin G, Bernal Brietzke M Priscila, Tan Naomi Q P, Douglas Elisa E, Coles Sarah, Ebell Mark H, Mejia Maria C, Kazerooni Ella A, Rosenthal Lauren, Smith Robert A

机构信息

Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Department of Oncology, Division of Population Science, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA.

出版信息

Cancer. 2025 Sep 1;131(17):e70008. doi: 10.1002/cncr.70008.

Abstract

Shared decision making is recommended for lung cancer screening (LCS) by professional organizations and payers. Patient decision aids can be used to support shared decision making, but they need to meet quality standards to minimize the potential for biased and poorly informed patient decisions. After the updated LCS recommendation from the US Preventive Services Task Force in 2021, the authors conducted an environmental scan of public-facing patient educational materials and evaluated them against criteria from the International Patient Decision Aid Standards for high-quality patient decision aids. The Google site search function was used to search websites from National Cancer Institute-funded cancer centers, professional societies, patient advocacy groups, cancer coalitions, and private organizations for educational materials on LCS. A general web search using Google, Google Scholar, and select databases was also conducted. Considerations unique to the LCS context (e.g., the importance of annual screening and smoking cessation) were documented. The search identified 96 educational materials that included information about both benefits and harms of LCS. Of these, 39 did not meet qualifying criteria for decision aids, with failure to explicitly identify LCS as a decision being the primary reason for exclusion. Only 10 of the remaining decision aids met quality criteria from the International Patient Decision Aid Standards. These aids emphasized that LCS should be performed annually, most avoided stigmatizing language, and several included personalization features using prediction models. Clinicians and patients can be confident in using these high-quality aids to complement the process of shared decision making for LCS. Validated aids in languages other than English and Spanish are needed.

摘要

专业组织和支付方推荐在肺癌筛查(LCS)中采用共同决策。患者决策辅助工具可用于支持共同决策,但它们需要符合质量标准,以尽量减少患者做出有偏差和信息不足决策的可能性。在美国预防服务工作组于2021年更新LCS建议后,作者对面向公众的患者教育材料进行了环境扫描,并根据国际患者决策辅助工具标准中高质量患者决策辅助工具的标准对其进行评估。利用谷歌网站搜索功能,在由美国国立癌症研究所资助的癌症中心、专业协会、患者权益倡导组织、癌症联盟和私人组织的网站上搜索有关LCS的教育材料。还使用谷歌、谷歌学术搜索和选定的数据库进行了一般网络搜索。记录了LCS背景下独有的考虑因素(例如年度筛查和戒烟的重要性)。搜索共识别出96份包含LCS利弊信息的教育材料。其中,39份不符合决策辅助工具的合格标准,未明确将LCS视为一项决策是被排除的主要原因。其余决策辅助工具中只有10份符合国际患者决策辅助工具标准的质量标准。这些辅助工具强调LCS应每年进行,大多数避免使用污名化语言,还有几份使用预测模型纳入了个性化功能。临床医生和患者可以放心使用这些高质量辅助工具来补充LCS的共同决策过程。需要有经过验证的非英语和西班牙语版本的辅助工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6745/12401189/08ad99903d2c/CNCR-131-e70008-g001.jpg

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