Shared Decision-Making During a Lung Cancer Screening Visit: Is It a Barrier or Does It Bring Value?
Shared Decision-Making During a Lung Cancer Screening Visit: Is It a Barrier or Does It Bring Value?
复制标题
肺癌筛查期间的共同决策：这是障碍还是带来价值？
DOI：
10.1016/j.chest.2022.07.024
复制
发表时间：
2023
期刊：
影响因子：
9.6
通讯作者：
Silvestri,GerardA
中科院分区：
文献类型：
--
作者：
Studts,JamieL;Hirsch,ErinA;Silvestri,GerardA
方法数据来自科罗拉多州所有付款人索赔数据库 (APCD)，其中包含科罗拉多州大多数受保人的保险索赔数据（商业、医疗保险服务费、医疗保险优势和医疗补助）。科罗拉多州 APCD 的描述和以前的数据使用，包括纳入和排除标准以及模型变量，已在其他地方进行了描述。 9 简而言之，提取的科罗拉多州 APCD 数据集包括从 2012 年 1 月 1 日到 2018 年 12 月 31 日期间，针对声称接受 LCS 特定低剂量 CT 扫描 (LDCT) 的个人的所有健康声明、程序代码和服务日期，并使用国际疾病分类 (ICD) 代码 S8032 和 G0297。我们通过计算索引 LDCT 索赔日期与数据集中可用的下一个后续 LDCT 索赔日期之间的时间，将年度遵守率定义为在指数 LDCT 后 15 个月内进行第二次 LDCT 索赔。该分析仅限于 2017 年 10 月 1 日之前进行过 LDCT 指数的个人，科罗拉多州 APCD 数据集中提供了完整的 15 个月的随访时间。在索引 LDCT 之前 90 天内提出 SDM 索赔的个人（以 ICD 代码 G0296 识别）被归类为接受过 SDM 咨询。使用逻辑回归来检验 SDM 咨询声明与年度依从性之间的关系。使用 SAS 软件（SAS 9.4；SAS Institute Inc）生成数据分析。该研究经科罗拉多州多机构审查委员会审查并确定豁免。 结果
MethodsData were obtained from the Colorado All Payer Claims Database (APCD), which contains insurance claims data (commercial, Medicare Fee-for-Service, Medicare Advantage, and Medicaid) for the majority of insured lives in Colorado. Description of the Colorado APCD and previous data use, which includes inclusion and exclusion criteria and model variables, have been described elsewhere. 9 Briefly, the extracted Colorado APCD dataset included all health claims, procedural codes, and dates of services from January 1, 2012, to December 31, 2018, for individuals with claims for a LCS specific low-dose CT scan (LDCT), with the use of International Classification of Diseases (ICD) codes S8032 and G0297. We defined annual adherence as having a second LDCT claim within 15 months of the index LDCT by calculating time between dates of the index LDCT claim and the next subsequent LDCT claim that were available in the dataset. This analysis was limited to individuals who had an index LDCT prior to October 1, 2017, with a complete 15 months of follow-up time available in the Colorado APCD dataset. Individuals with a SDM claim within 90 days preceding the index LDCT, identified with an ICD code of G0296, were classified as having had a SDM consultation. Logistic regression was used to examine the relationship between an SDM consultation claim and annual adherence. Data analysis was generated with the use of SAS software (SAS 9.4; SAS Institute Inc). The study was reviewed by the Colorado Multiple Institutional Review Board and determined to be exempt.Results