October 2018 (JAMA Internal Medicine)
The US Preventive Services Task Force recommends for a thorough discussion between patients and clinicians prior to lung cancer screening (LCS) through a process called shared decision making (SDM).
The Centers for Medicare and Medicaid Services actually requires a SDM discussion prior to coverage for LCS.
Nevertheless, little research has been done on how SDM for LCS occurs in practice, and if SDM is being done in accordance to the aforementioned recommendations.
Research lead by Dr. Alison T. Brenner from the University of North Carolina at Chapel Hill and a host of her colleagues conducted a qualitative content analysis to better understand if SDM is used in practice for LCS and if it positively affects patient outcomes.
In this study published in JAMA Internal Medicine, 14 clinical encounters were recorded and analyzed, and the analysis showed that the quality of SDM regarding LCS was poor. Although all the tested physicians recommended LCS to their patients, discussion of its harms was almost non-existent, mean discussion length was only 13:07 minutes, actual time spent discussing LCS was 59 seconds on average, and there is no evidence that additional patient education materials for LCS were used.
Dr. Brenner and her research team emphasize the importance of further research – as this was only a small-scale study – but that this research does indicate SDM for LCS may not be as effective in practice as the guidelines intend.