Smokers who watched a video and read a brochure on the potential harms and benefits of CT lung cancer screening had a better understanding of the exam and had more confidence in their decision to get screened, according to an article published online April 17 in the Annals of the American Thoracic Society.
Researchers from the U.K. produced a 5.5-minute educational video and a brochure that describe key aspects of CT lung screening. Both were formatted in an engaging and easy-to-follow manner, without overemphasizing the exam's risks or advantages.
The group set out to determine the extent to which these informational decision tools facilitated dialogue about CT lung screening between eligible smokers and their physicians, as well as how frequently they led to shared decision-making.
"We used feedback from other patients eligible for lung cancer screening to create a film that individuals from a variety of educational backgrounds could understand and that presented the information in a clear, simple, and palatable manner," senior study author Dr. Sam Janes, PhD, from University College London said in a statement to the American Thoracic Society.
Janes and colleagues offered either the brochure or both the brochure and video to 229 participants in the U.K. Lung Screen Uptake Trial (LSUT) who met one of three distinct sets of eligibility criteria for CT lung screening, including the criteria established by the U.S. Preventive Services Task Force.
After exposure to the decision tools, approximately 77% of the participants of both groups agreed to undergo a CT lung screening exam. Both decision tools were also associated with statistically significant improvements in the participants' scores on an objective knowledge test that evaluated their ability to recall facts about CT lung screening as well as on a self-assessment knowledge test.
However, the improvements in average score were greater by a statistically significant degree for the video and brochure group. The participants' mean scores increased by 3.2 percentage points more on the objective test and 7.4 percentage points more on the subjective test for the video and brochure group, compared with the brochure-only group.
| Effect of educational brochure and video on smokers' CT lung screening knowledge | ||
| Averages | Brochure | Video + brochure |
| Improvement in objective knowledge test score* | 18.4% | 21.6% |
| Improvement in subjective knowledge test score* | 11% | 18.4% |
| Decisional certainty in undergoing CT lung screening | 91.1% | 94.4% |
In addition, those who watched the video and read the brochure claimed to be more confident in their decision to undergo the exam, with a certainty level of 8.5 out of 9, compared with 8.2 for those who only read the brochure.
"There is an urgent unmet need to provide information to individuals considering lung cancer screening, but for this to be done in a nonintimidating, friendly, and simple way," lead author Dr. Mamta Ruparel, PhD, said. "This study demonstrates that an information film can enhance shared decision-making, while reducing the conflicted feelings patients may have about undergoing the procedure without reducing low-dose CT screening participation."
