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. 2022 Oct;162(4):930-941.
doi: 10.1016/j.chest.2021.12.638. Epub 2021 Dec 16.

Decision Support Tools for Low-Dose CT Lung Cancer Screening: A Scoping Review of Information Content, Format, and Presentation Methods

Mbasan Jallow  1 , Stefanie Bonfield  2 , Clara Kurtidu  3 , David R Baldwin  4 , Georgia Black  5 , Kate E Brain  6 , Michael Donnelly  7 , Samuel M Janes  8 , Grace McCutchan  6 , Kathryn A Robb  3 , Mamta Ruparel  8 , Sandra Van Os  5 , Samantha L Quaife  9
Affiliations

Decision Support Tools for Low-Dose CT Lung Cancer Screening: A Scoping Review of Information Content, Format, and Presentation Methods

Mbasan Jallow et al. Chest. 2022 Oct.

Abstract

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.

Keywords: decision support tools; health inequality; informed decision-making; lung cancer screening; shared decision-making.

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Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews flowchart of the search and inclusion process. LDCT = low-dose CT.
Figure 2
Figure 2
Bar graph showing the methods used to quantify the probability of each benefit and harm of low-dose CT scan LC screening. DST = decision support tool; LC = lung cancer.
Figure 3
Figure 3
Bar graph showing the methods used to present each benefit and harm of low-dose CT scan LC screening. DST = decision support tool; LC = lung cancer.
Figure 4
Figure 4
Bar graph showing the methods used to quantify the probability of each type of low-dose CT scan LC screening results. DST = decision support tool; LC = lung cancer.
Figure 5
Figure 5
Bar graph showing the methods used to present each type of low-dose CT scan lung cancer screening result. DST = decision support tool.
See this image and copyright information in PMC

References

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