ArticleBMJ open2021
What is the effect of a decision aid on knowledge, values and preferences for lung cancer screening? An online pre-post study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Lung cancer screening completion among patients using decision aids: a systematic review and meta-analysis.Cancer causes & control : CCC · 2025Pooled it
- Patient barriers and facilitators to lung cancer screening uptake and intention to screen: a systematic review using the Theoretical Domains Framework.BMJ open respiratory research · 2025Pooled it
- The impact of decision tools during oncological consultation with lung cancer patients: A systematic review within the I3LUNG project.Cancer medicine · 2024Pooled it
- Digital Interventions to Support Lung Cancer Screening: A Systematic Review.American journal of preventive medicine · 2024Pooled it
- Lung Cancer Screening Decision Aid Designed for a Primary Care Setting: A Randomized Clinical Trial.JAMA network open · 2023Trial
- Effect of Incidental Findings Information on Lung Cancer Screening Intent: a Randomized Controlled Trial.Journal of general internal medicine · 2022Trial
- Effectiveness of Technology-Based Interventions in Promoting Lung Cancer Screening Uptake and Decision-Making Among Patients.International journal of environmental research and public health · 2025Review
- Developing a digital video to support lung cancer screening in diverse populations.PEC innovation · 2025Article
- The Use of a Tailored Decision Aid to Improve Understanding of Lung Cancer Screening in People With HIV.Chest · 2025Observational
- Application of Amiodarone and Cedilan in the Treatment of Patients with Arrhythmia after Esophageal and Lung Cancer.Evidence-based complementary and alternative medicine : eCAM · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine if a decision aid improves knowledge of lung cancer screening benefits and harms and which benefits and harms are most valued.
designPre-post study.
settingOnline.
participants219 current or former (quit within the previous 15 years) smokers ages 55-80 with at least 30 pack-years of smoking.
interventionLung cancer screening video decision aid. MAIN MEASURES: Screening knowledge tested by 10 pre-post questions and value of benefits and harms (reducing chance of death from lung cancer, risk of being diagnosed, false positives, biopsies, complications of biopsies and out-of-pocket costs) assessed through rating (1-5 scale) and ranking (top three ranked).
resultsMean age was 64.7±6.1, 42.5% were male, 75.4% white, 48.4% married, 28.9% with less than a college degree and 67.6% with income <US$50 000. Knowledge improved postdecision aid (pre 2.8±1.8 vs post 5.8±2.3, diff +3.0, 95% CI 2.7 to 3.3; p<0.001). For values, reducing the chance of death from lung cancer was rated and ranked highest overall (rating 4.3±1.0; 59.4% ranked first). Among harms, avoiding complications (3.7±1.3) and out-of-pocket costs (3.7±1.2) rated highest. Thirty-four per cent ranked one of four harms highest: avoiding costs 13.2%, false positives 7.3%, biopsies 7.3%, complications 5.9%. Screening intent was balanced (1-4 scale; 1-not likely 21.0%, 4-very likely 26.9%). Those 'not likely' to screen had greater improvement in pre-post knowledge scores and more frequently ranked a harm first than those 'very likely' to screen (pre-post diff:+3.5 vs +2.6, diff +0.9; 95% CI 0.1 to 1.8; p=0.023; one of four harms ranked first: 28.4% vs 11.3%, p<0.001).
conclusionsOur decision aid increased lung cancer screening knowledge among a diverse sample of screen-eligible respondents. Although a majority valued 'reducing the chance of death from lung cancer' highest, a substantial proportion identified harms as most important. Knowledge improvement and ranking harms highest were associated with lower intention to screen.
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