CHEST Guidelines-Shared-Decision-making-and-Lung-Cancer-Screening

Shared-Decision-making-and-Lung-Cancer-Screening_2 (1)

Pdf Summary

The article "Shared Decision-making and Lung Cancer Screening: Let's Get the Conversation Started" by Nichole T. Tanner, MD, and Gerard A. Silvestri, MD, discusses the intricate process of shared decision-making (SDM) in lung cancer screening (LCS). Using low-dose CT scans for LCS can reduce lung cancer mortality in high-risk individuals, but the decision to undergo screening is complex, requiring careful consideration of risks and benefits. SDM is essential in navigating these complexities, allowing patients and healthcare providers to collaborate in making well-informed decisions that align with patient values and preferences.<br /><br />The Centers for Medicare and Medicaid Services require SDM as a prerequisite for reimbursing LCS, highlighting its importance. Despite its significance, clinicians often overlook SDM due to misunderstandings, time constraints, and assumptions that patients are disinterested in participating in decision-making processes.<br /><br />The article highlights barriers to effective SDM including limited clinician training and knowledge gaps in LCS criteria and risks. Patients frequently misestimate screening's benefits and harms, leading to suboptimal decision-making. Decision aids can facilitate SDM by providing balanced information and clarifying patient values, yet their adoption in practice is inconsistent.<br /><br />The review emphasizes the potential of telehealth in enhancing SDM for LCS, particularly for underserved populations. Conducting SDM via telephone can alleviate logistical challenges and improve patient satisfaction, offering an effective alternative to in-person consultations.<br /><br />Educating both clinicians and patients, integrating decision aids, and exploring innovative SDM methodologies can enhance decision-making quality. As LCS becomes more prevalent, SDM serves not only as a tool for patient collaboration but also as a gateway for tobacco cessation discussions, ultimately contributing to improved mortality outcomes.

Keywords

shared decision-making

lung cancer screening

low-dose CT scans

patient collaboration

decision aids

telehealth

clinician training

patient education

tobacco cessation

mortality outcomes