Abstract A18: An enhanced shared decision-making model to address willingness and ability to undergo lung cancer screening and follow-Up treatment

C. Erkmen, Mark Mitchell, S. Randhawa, S. Sferra, Rachel Kim, V. DiSesa, L. Kaiser, G. Ma
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Abstract

Background: Failure to address willingness and ability to undergo lung cancer treatment before lung cancer screening could cause patients unnecessary anxiety, cost, and care. We employed an enhanced shared decision-making (SDM) model to address willingness and ability to undergo lung cancer screening of low-dose CT (LDCT) scanning. We hypothesized that enhanced SDM was feasible and did not discourage patients from undergoing lung cancer screening. Methods: We performed a prospective study of patients referred for lung cancer screening. We measured adherence to the LCS protocol, including consent to discuss lung cancer treatment if cancer is found and direct questions to patients about willingness and ability to undergo lung cancer treatment. We measured race, gender, adherence to the consent process, and questions regarding willingness and ability to undergo lung cancer treatment and subsequent uptake of LDCT. Results: All 190 patients have a documented SDM visit addressing the risks and benefits of lung cancer screening and consented to discuss lung cancer treatment if lung cancer is diagnosed. One hundred and seventy-nine (179) of 190 (94%) answered yes to being willing and able to undergo lung cancer treatment. One hundred and eighty-seven (187) patients underwent LDCT (98.4%). Conclusions: Discussion about willingness and ability to undergo lung cancer treatment should be an essential component of an SDM discussion prior to LDCT. This study demonstrated that an enhanced SDM experience is feasible in a clinical setting. Furthermore, patients proceeded with LDCT following the enhanced SDM process. Citation Format: Cherie P. Erkmen, Mark Mitchell, Simran Randhawa, Shelby Sferra, Rachel Kim, Verdi DiSesa, Larry R. Kaiser, Grace X. Ma. An enhanced shared decision-making model to address willingness and ability to undergo lung cancer screening and follow-Up treatment [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A18.
A18:一种增强的共享决策模型,以解决接受肺癌筛查和随访治疗的意愿和能力
背景:在肺癌筛查前不考虑接受肺癌治疗的意愿和能力可能会导致患者不必要的焦虑、费用和护理。我们采用增强型共享决策(SDM)模型来解决接受低剂量CT (LDCT)扫描肺癌筛查的意愿和能力问题。我们假设增强的SDM是可行的,并且不会阻止患者接受肺癌筛查。方法:我们对接受肺癌筛查的患者进行了一项前瞻性研究。我们测量了LCS方案的依从性,包括同意在发现癌症时讨论肺癌治疗,以及直接询问患者接受肺癌治疗的意愿和能力。我们测量了种族、性别、对同意过程的依从性,以及有关接受肺癌治疗和随后接受LDCT的意愿和能力的问题。结果:所有190名患者都进行了记录在案的SDM访问,讨论了肺癌筛查的风险和益处,并同意在诊断为肺癌时讨论肺癌治疗。190人中有179人(94%)回答愿意并能够接受肺癌治疗。187例患者行LDCT检查(98.4%)。结论:讨论接受肺癌治疗的意愿和能力应该是LDCT前SDM讨论的重要组成部分。该研究表明,在临床环境中,增强SDM体验是可行的。此外,患者在增强的SDM过程后进行LDCT。引文格式:Cherie P. Erkmen, Mark Mitchell, Simran Randhawa, Shelby Sferra, Rachel Kim, Verdi DiSesa, Larry R. Kaiser, Grace X. Ma。一种增强的共享决策模型,以解决接受肺癌筛查和随访治疗的意愿和能力[摘要]。见:第十届AACR会议论文集:种族/少数民族和医疗服务不足人群的癌症健康差异科学;2017年9月25-28日;亚特兰大,乔治亚州。费城(PA): AACR;癌症流行病学杂志,2018;27(7增刊):摘要nr A18。
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