Evidence map›Paper›PMID 38527820›Full record

ArticleAnnals of family medicine

Challenges Addressing Lung Cancer Screening for Patients With Multimorbidity in Primary Care: A Qualitative Study.

Minal S Kale, Orly Morgan, Juan Wisnivesky, Julie Schnur, Michael A Diefenbach

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
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 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
6.5field-weighted citation impact, top 3% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
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

5 authors at 3 institutions in 1 country.

Minal S KaleDivision of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York minal.kale@mountsinai.org.
Orly MorganDivision of Medical Education, University of Miami Miller School of Medicine, Miami, Florida.
Juan WisniveskyDivision of Medical Education, University of Miami Miller School of Medicine, Miami, Florida.
Julie SchnurDepartment of Population Health Science and Policy, Center for Behavioral Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
Michael A DiefenbachInstitute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, New York.
Icahn School of Medicine at Mount Sinai · USUniversity of Miami · USFeinstein Institute for Medical Research · US

Funding

Investigating the Roles of Patient Beliefs, Stigma, and Physician Implicit Bias on Disparities in Lung Cancer ScreeningR01MD014890 · NIMHD · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KALE, MINAL S, SMITH, CARDINALE B · 2021 to 2025
$4.1M
Training Cancer Care Providers to Implement Sensitive Practice Guidelines When Treating Adult Survivors of Sexual Violence: A Blended Learning ApproachR25CA236636 · NCI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Julie B. Schnur · 2019 to 2026
$1.4M
NCI NIH HHS R25 CA236636NIMHD NIH HHS R01 MD014890
6 · The paper itself

Abstract

purposeMany individuals who are eligible for lung cancer screening have comorbid conditions complicating their shared decision-making conversations with physicians. The goal of our study was to better understand how primary care physicians (PCPs) factor comorbidities into their evaluation of the risks and benefits of lung cancer screening and into their shared decision-making conversations with patients.

methodsWe conducted semistructured interviews by videoconference with 15 PCPs to assess the extent of shared decision-making practices and explore their understanding of the intersection of comorbidities and lung cancer screening, and how that understanding informed their clinical approach to this population.

resultsWe identified 3 themes. The first theme was whether to discuss or not to discuss lung cancer screening. PCPs described taking additional steps for individuals with complex comorbidities to decide whether to initiate this discussion and used subjective clinical judgment to decide whether the conversation would be productive and beneficial. PCPs made mental assessments that factored in the patient's health, life expectancy, quality of life, and access to support systems. The second theme was that shared decision making is not a simple discussion. When PCPs did initiate discussions about lung cancer screening, although some believed they could provide objective information, others struggled with personal biases. The third theme was that ultimately, the decision to be screened was up to the patient. Patients had the final say, even if their decision was discordant with the PCP's advice.

conclusionsShared decision-making conversations about lung cancer screening differed substantially from the standard for patients with complex comorbidities. Future research should include efforts to characterize the risks and benefits of LCS in patients with comorbidities to inform guidelines and clinical application.

Indexed as

Early Detection of CancerLung NeoplasmsDecision MakingHumansMultimorbidityPrimary Health CareQuality of Lifebeneficenceclinical reasoningcomorbiditiescounselingeducation of patientsholistic healthjudgmentlife expectancylung cancer screeningmultimorbiditypaternalismpatient-centered carepersonal autonomypractice-based researchpreventive medicineprimary carequality of liferisk-benefit assessmentshared decision making

Identifiers

PMID38527820
PMCPMC11237206
OpenAlexW4393168050

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.