title: Evaluation of a Personalized, Web-Based Decision Aid for Lung Cancer Screening.
abstract: BACKGROUND
  Informed decision making has been highlighted as an important aspect of lung cancer screening programs. This study seeks to assess the efficacy of a web-based patient decision aid for lung cancer screening, www.shouldiscreen.com.
  
  
  METHODS
  A before-and-after study (August through December 2014) was conducted where participants navigated a web-based decision aid that provided information about low-dose computed tomography lung cancer screening. Using an established prediction model, the decision aid computed baseline lung cancer risk and an individual's chances of benefiting from, and risk of being harmed by, screening. Outcome measures included knowledge of lung cancer risk factors and lung cancer screening, decisional conflict, concordance, and acceptability of the decision aid. Data were collected from 60 participants who were current or former smokers, had no history of lung cancer, and had not received a chest computed tomographic scan in the previous year. Analysis took place in 2015.
  
  
  RESULTS
  Knowledge increased after seeing the decision aid compared with before (p<0.001), whereas the score on the Decisional Conflict Scale decreased (p<0.001). Concordance between a participant's preference to screen and the U.S. Preventive Services Task Force recommendation improved after seeing the decision aid (p<0.001). Risk perceptions among the screen-ineligible group changed (n=49), contrary to those who were eligible (n=11). Ninety-seven percent of the participants reported that the decision aid was likely useful for lung cancer screening decision making.
  
  
  CONCLUSIONS
  The web-based decision aid should be a helpful resource for individuals considering lung cancer screening, as well as for practitioners and health systems with lung cancer screening programs.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Yan Kwan
authors.initials: YK
authors.lastname: Lau
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan; Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
authors.forename: Tanner J
authors.initials: TJ
authors.lastname: Caverly
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Pianpian
authors.initials: P
authors.lastname: Cao
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Cherng
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Mindy
authors.initials: M
authors.lastname: West
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Charles
authors.initials: C
authors.lastname: Gaber
authors.affiliation: Division of Pulmonary and Critical Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Douglas
authors.initials: D
authors.lastname: Arenberg
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan. Electronic address: rmeza@umich.edu.
authors.forename: Rafael
authors.initials: R
authors.lastname: Meza
mesh_terms: D000368:Aged; D003661:Decision Support Techniques; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D020407:Internet; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010358:Patient Participation