Evidence map›Paper›PMID 38527813›Full record

ArticleAnnals of family medicine

"It Can't Hurt!": Why Many Patients With Limited Life Expectancy Decide to Accept Lung Cancer Screening.

Eduardo R Núñez, Rendelle E Bolton, Jacqueline H Boudreau, Samantha K Sliwinski, Abigail N Herbst, Lauren E Kearney, Tanner J Caverly, Renda Soylemez Wiener

Open access · diamondAbstract read
In one paragraph

Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Eduardo R NúñezCenter for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts and VA Bedford Healthcare System, Bedford, Massachusetts eduardo.nunez2@baystatehealth.org.
Rendelle E BoltonCenter for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts and VA Bedford Healthcare System, Bedford, Massachusetts.
Jacqueline H BoudreauCenter for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts and VA Bedford Healthcare System, Bedford, Massachusetts.
Samantha K SliwinskiCenter for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts and VA Bedford Healthcare System, Bedford, Massachusetts.
Abigail N HerbstCenter for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts and VA Bedford Healthcare System, Bedford, Massachusetts.
Lauren E KearneyCenter for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts and VA Bedford Healthcare System, Bedford, Massachusetts.
Tanner J CaverlyNational Center for Lung Cancer Screening, Veterans Health Administration, Washington, DC.
Renda Soylemez WienerCenter for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts and VA Bedford Healthcare System, Bedford, Massachusetts.
VA Boston Healthcare System · USBoston University · USBaystate Health · USUniversity of Michigan–Ann Arbor · US

Funding

BIOLOGY OF THE LUNG--MULTIDISCIPLINARY PROGRAMT32HL007035 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Darrell N. Kotton, JOSEPH P MIZGERD · 1985 to 2026
$24.3M
NHLBI NIH HHS T32 HL007035
6 · The paper itself

Abstract

purposeLung cancer screening (LCS) has less benefit and greater potential for iatrogenic harm among people with multiple comorbidities and limited life expectancy. Yet, such individuals are more likely to undergo screening than healthier LCS-eligible people. We sought to understand how patients with marginal LCS benefit conceptualize their health and make decisions regarding LCS.

methodsWe interviewed 40 people with multimorbidity and limited life expectancy, as determined by high Care Assessment Need scores, which predict 1-year risk of hospitalization or death. Patients were recruited from 6 Veterans Health Administration facilities after discussing LCS with their clinician. We conducted a thematic analysis using constant comparison to explore factors that influence LCS decision making.

resultsPatients commonly held positive beliefs about screening and perceived LCS to be noninvasive. When posed with hypothetical scenarios of limited benefit, patients emphasized the nonlongevity benefits of LCS (eg, peace of mind, planning for the future) and generally did not consider their health status or life expectancy when making decisions regarding LCS. Most patients were unaware of possible additional evaluations or treatment of screen-detected findings, but when probed further, many expressed concerns about the potential need for multiple evaluations, referrals, or invasive procedures.

conclusionsPatients in this study with multimorbidity and limited life expectancy were unaware of their greater risk of potential harm when accepting LCS. Given patient trust in clinician recommendations, it is important that clinicians engage patients with marginal LCS benefit in shared decision making, ensuring that their values of desiring more information about their health are weighed against potential harms from further evaluations.

Indexed as

Lung NeoplasmsComorbidityDecision MakingEarly Detection of CancerHumansLife ExpectancyMass Screeningcancer: screeningchronic care: comorbidity/multimorbiditylung cancerlung cancer screeningprimary care issues: patient-centered carequalitative methods: key informant/depth interviewing

Identifiers

PMID38527813
PMCPMC11237214
OpenAlexW4393166759

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.