ArticlePatient education and counseling2025
Navigating shared decision-making in lung cancer screening: Insights into barriers, training, and referral propensity among clinicians.
Article in Patient education and counseling, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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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
2 citing papers in PubMed.
- Mixed-Method Formative Evaluation and Cultural Adaptation of Digital Health Communication Content and Delivery Promoting Lung Cancer Screening Shared Decision-Making.Cancer control : journal of the Moffitt Cancer CenterTrial
- Independent Predictors Associated with Patient Refusal of Invasive Diagnostic Procedures After Positive LDCT Lung Cancer Screening.Diagnostics (Basel, Switzerland) · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectivesShared decision-making (SDM) is critical in lung cancer screening (LCS), enabling clinicians to guide patients through complex benefit-risk discussions. Despite its endorsement by professional organizations and its Medicare reimbursement requirement, SDM implementation in clinical practice remains inconsistent. This cross-sectional study evaluated factors influencing clinician knowledge, attitudes, and referral behaviors regarding LCS within a decentralized screening program.
methodsWe surveyed 125 primary care clinicians (PCCs) in a large integrated health system, linking responses to electronic health record data to assess LCS referral propensity. Clinicians reported perceived barriers to SDM, attitudes toward SDM and LCS, and knowledge via clinical vignettes. Multivariable analyses identified key predictors of attitudes and behaviors.
resultsFindings revealed that perceived barriers to SDM, particularly time burden, significantly influenced attitudes toward LCS (β = -0.334, p < 0.001) and referral propensity (β = -0.305, p = 0.0005). Formal training in SDM for LCS was positively associated with favorable SDM attitudes (β = 0.035, p = 0.0248), emphasizing the potential of targeted interventions. Time burden emerged as a critical determinant of perceived barriers (β = 0.728, p < 0.001), highlighting the need for systemic and educational solutions.
conclusionsThese results underscore the importance of reducing SDM-related time burdens and enhancing training to improve clinician engagement and screening outcomes. Innovative strategies, such as patient-tailored pre-visit education and team-based care models, could mitigate barriers and promote more effective SDM implementation. Future research should explore longitudinal and multi-system analyses to refine interventions and optimize LCS processes. PRACTICE IMPLICATIONS: By addressing systemic and individual barriers, health systems can enhance SDM efficacy, increasing LCS uptake and improving care for screening-eligible populations. This study offers actionable insights for advancing patient-centered approaches in LCS and broader preventive health initiatives.
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Registered trials
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.