Scalable decision support and shared decision making for lung cancer screening

项目总结 肺癌是美国第二种最常见的癌症，也是最常见的致癌原因 在男性和女性中与癌症相关的死亡人数。一种被称为低剂量计算机的筛查测试 体层摄影术(LDCT)可以早期发现肺癌，减少肺癌死亡率。 重度吸烟史，但这项测试要求患者和他们的医生考虑潜在的益处和 根据每个患者的个人风险情况不同的危害，只有不到5%的符合条件的患者受到 每年的放映。该项目将通过分析患者的电子健康来解决这一迫切需求 记录，促使符合条件的患者和他们的医生考虑肺癌筛查，并提供 个人定制的关于肺癌筛查潜在益处和危害的信息，以便患者 他们的医生可以在知情的情况下，以患者为中心，就这项可能挽救生命的测试做出决定。 该项目将建立在LDCT共享决策的独立工具的基础上，该工具已逐步 由项目团队通过真实世界的临床使用进行增强，它将与电子产品完全集成 健康记录(EHR)，以便它可以引入相关的患者风险数据并与常规无缝集成 临床工作流程。这个我们称为Decision Precision+的工具将提供有关以下内容的个性化信息 筛查的潜在好处和坏处，使患者和他们的医生能够做出知情和 以患者为中心的决定是否通过LDCT测试筛查肺癌。其他工具还将 为促使符合条件的患者使用Decision Precision+和收集所需的吸烟而开发 当历史遗失的时候。在其设计和开发之后，将实施Decision Precision+，并 在犹他大学健康中心的初级保健诊所进行评估。Decision Precision+也将进行 可作为免费工具提供给其他医疗保健组织，可下载并与其自己的电子病历一起使用 系统。项目团队将支持其他医疗保健组织使用Decision Precision+，因此 尽可能多的患者可以受益于适当的LDCT测试和相关的减少 死于肺癌。

PROJECT SUMMARY Lung cancer is the second most commonly diagnosed cancer in the United States, and it is the leading cause of cancer-related deaths among both men and women. A screening test known as low-dose computed tomography (LDCT) can detect lung cancer early and reduce lung cancer deaths among individuals with a history of heavy smoking, but this test requires patients and their physicians to consider potential benefits and harms that differ according to each patient’s individual risk profile, and less than 5% of eligible patients receive the screening every year. This project will address this urgent need by analyzing patients’ electronic health records, prompting eligible patients and their physicians to consider lung cancer screening, and providing individually-tailored information on the potential benefits and harms of lung cancer screening, so that patients and their physicians can make informed, patient-centered decisions regarding this potentially life-saving test. This project will build off of a stand-alone tool for LDCT shared decision making that has been progressively enhanced by the project team through real-world clinical use, and it will be fully integrated with the electronic health record (EHR) so that it can pull in relevant patient risk data and be seamlessly integrated with routine clinical workflows. This tool, which we call Decision Precision+, will present individually-tailored information on the potential benefits and harms of screening, enabling patients and their physicians to make informed and patient-centered decisions on whether to screen for lung cancer through LDCT testing. Additional tools will also be developed for prompting use of Decision Precision+ for eligible patients and for collecting required smoking history when it is missing. Following its design and development, Decision Precision+ will be implemented and evaluated at the primary care clinics of University of Utah Health. Decision Precision+ will also be made available to other healthcare organizations as a free tool that can be downloaded and used with their own EHR systems. The project team will support the use of Decision Precision+ by other healthcare organizations, so that as many patients as possible can benefit from appropriate LDCT testing and associated reductions in deaths due to lung cancer.