Online Decision AID vs Option Grid in Shared Decision Making Prior to Lung Cancer Screening

Abstract

PURPOSE: In lung cancer screening, a process of Shared Decision Making (SDM) is utilized by health care providers to help patients understand potential harms and benefits of screening. SDM is not only supported by the USPSTF, but it is also a required element for reimbursement under CMS. Despite the importance of SDM, there are no evidence-based guidelines on methods of conducting SDM. Our pilot study compares two SDM methods: an online decision aid and option grids, to determine if these methods are equivalent in guiding patients through screening. METHOD(S): We conducted a randomized trial in which lung cancer screening patients underwent SDM using shouldiscreen, an online decision aid, or an option grid, a brief information sheet used to guide a physician-patient encounter. After screening, patients discussed their experience using CollaboRATE, a validated SDM assessment tool. Patients were then followed up via telephone to answer a knowledge retention questionnaire. RESULT(S): In 6 months, 238 patients received SDM with shouldiscreen vs. option grids. The patients did not statistically differ in demographics. After SDM, the patients' knowledge retention scores were not statistically different (p=0.64) and remained statistically insignificant when stratified by education (p=0.83). In addition, the patients' CollaboRATE scores were virtually identical (p=0.60). There was a positive correlation between education level and knowledge retention for patients using the option grid, but this relationship did not exist for patients using shouldiscreen. CONCLUSION(S): In our study, we were able to integrate two validated SDM tools into a large, academic medical center. When comparing these SDM options, shouldiscreen and option grids were equivalent in the knowledge imparted and satisfaction with the SDM process.