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

Mbasan Jallow; Stefanie Bonfield; Clara Kurtidu; David R Baldwin; Georgia Black; Kate E Brain; Michael Donnelly; Samuel M Janes; Grace McCutchan; Kathryn A Robb; Mamta Ruparel; Sandra Van Os; Samantha L Quaife

doi:10.1016/j.chest.2021.12.638

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

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

Authors

Affiliations

¹ Research Department of Behavioural Science and Health, University College London, London, England.
² Research Department of Behavioural Science and Health, University College London, London, England; Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, England.
³ Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
⁴ Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, City Hospital, Nottingham, England.
⁵ Department of Applied Health Research, University College London, London, England.
⁶ Division of Population Medicine, Cardiff University, Cardiff, Wales.
⁷ Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.
⁸ Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, England.
⁹ Research Department of Behavioural Science and Health, University College London, London, England; Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, England. Electronic address: s.quaife@qmul.ac.uk.

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.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Decision Making
Decision Support Techniques
Early Detection of Cancer*
Humans
Lung Neoplasms* / diagnostic imaging
Tomography, X-Ray Computed

Abstract

Publication types

MeSH terms

Grants and funding