Abstract：
BACKGROUND: People with HIV are at increased risk for lung cancer and multimorbidity, complicating the balance of risks and benefits of lung cancer screening. We previously adapted Decision Precision (screenlc.com) to guide shared decision-making for lung cancer screening in people with HIV.
OBJECTIVE: Does an HIV-adapted and personally tailored decision aid improve shared decision-making regarding lung cancer screening in people with HIV as measured by knowledge, decisional conflict, and acceptability?
METHODS: This was a single-arm pilot trial of the decision aid in 40 participants with HIV eligible for lung cancer screening. The decision aid included personalized screening recommendations and HIV-specific, 5-year risk estimates of lung cancer and all-cause mortality. Participants reviewed the decision aid at shared decision-making visits and completed previsit and postvisit surveys with measures of knowledge about lung cancer screening, acceptability, and decisional conflict.
RESULTS: The 40 enrolled participants were a median 62 years old, 60% were currently smoking, and they had median 5-year risks of lung cancer and all-cause mortality of 2.0% (IQR, 1.4%-3.3%) and 4.1% (IQR, 3.3%-7.9%), respectively. Personalized recommendations included \"Encourage Screening\" for 53% of participants and \"Preference Sensitive\" recommendations for the remainder. Participants showed improvement in 2 validated knowledge measures with relative improvement of 60% (P < 0.001) on the 12-question lung cancer screening knowledge test and 27% (P < .001) on the 7-question lung cancer screening knowledge score, with significant improvement on questions regarding false-positive and false-negative findings, incidental findings, lung cancer-specific mortality benefit, and the possible harms of screening. Participants reported low scores on the decisional conflict scale (median score, 0; IQR, 0-5) and high acceptability. Ninety percent of patients ultimately underwent screening within 1 month of the visit.
CONCLUSIONS: This HIV-adapted and personally tailored decision aid improved participants\' knowledge of risks, benefits, and characteristics of screening with low decisional conflict and high acceptability. This decision aid can enable high-quality shared decision-making in this high-risk population.
BACKGROUND: ClinicalTrials.gov; No.: NCT04682301; URL: www.
RESULTS: gov.
OBJECTIVE: Does an HIV-adapted and personally tailored decision aid improve shared decision-making regarding lung cancer screening in people with HIV as measured by knowledge, decisional conflict, and acceptability?
METHODS: This was a single-arm pilot trial of the decision aid in 40 participants with HIV eligible for lung cancer screening. The decision aid included personalized screening recommendations and HIV-specific, 5-year risk estimates of lung cancer and all-cause mortality. Participants reviewed the decision aid at shared decision-making visits and completed previsit and postvisit surveys with measures of knowledge about lung cancer screening, acceptability, and decisional conflict.
RESULTS: The 40 enrolled participants were a median 62 years old, 60% were currently smoking, and they had median 5-year risks of lung cancer and all-cause mortality of 2.0% (IQR, 1.4%-3.3%) and 4.1% (IQR, 3.3%-7.9%), respectively. Personalized recommendations included \"Encourage Screening\" for 53% of participants and \"Preference Sensitive\" recommendations for the remainder. Participants showed improvement in 2 validated knowledge measures with relative improvement of 60% (P < 0.001) on the 12-question lung cancer screening knowledge test and 27% (P < .001) on the 7-question lung cancer screening knowledge score, with significant improvement on questions regarding false-positive and false-negative findings, incidental findings, lung cancer-specific mortality benefit, and the possible harms of screening. Participants reported low scores on the decisional conflict scale (median score, 0; IQR, 0-5) and high acceptability. Ninety percent of patients ultimately underwent screening within 1 month of the visit.
CONCLUSIONS: This HIV-adapted and personally tailored decision aid improved participants\' knowledge of risks, benefits, and characteristics of screening with low decisional conflict and high acceptability. This decision aid can enable high-quality shared decision-making in this high-risk population.
BACKGROUND: ClinicalTrials.gov; No.: NCT04682301; URL: www.
RESULTS: gov.
摘要：
背景：HIV感染者患肺癌和多发病的风险增加，使肺癌筛查的风险和收益平衡复杂化。我们之前调整了DecisionPrecision（screenlc.com），以指导HIV感染者肺癌筛查的共同决策。
目标：根据知识衡量，适应艾滋病毒和个人定制的决策辅助是否可以改善艾滋病毒感染者肺癌筛查的共同决策？决策冲突，和可接受性？
方法：这是一项单臂试点试验，对40名符合肺癌筛查条件的HIV患者进行决策辅助。决策援助包括个性化筛查建议和艾滋病毒特异性，肺癌和全因死亡率的五年风险估计。参与者在共享决策访问中审查了决策援助，并完成了访问前和访问后的调查，其中包括有关肺癌筛查的知识。可接受性,和决策冲突。
结果：40名参与者的年龄中位数为62岁，60％目前吸烟，5年肺癌风险中位数为2.0％（IQR1.4-3.3％）和4.1％（IQR3.3-7.9％）。个性化建议包括53％的参与者的“鼓励筛查”和其余的“偏好敏感”建议。参与者在两个有效的知识测量中表现出改善，LCS-12的相对改善为60％（p<0.001），LKS-7的相对改善为27％（p<0.001），在有关假阳性和假阴性的问题上有显着改善。偶然发现，肺癌特异性死亡率获益，以及筛查可能的危害。参与者在决策冲突量表上得分较低（中位数为0，IQR为0-5），可接受性较高。90%的人最终在访问后的一个月内接受了筛查。
结论：这种适应艾滋病毒和个人定制的决策帮助提高了参与者的风险知识，好处,筛选具有决策冲突低、可接受性高的特点。这种决策辅助可以在这个高风险人群中实现高质量的共享决策。
目标：根据知识衡量，适应艾滋病毒和个人定制的决策辅助是否可以改善艾滋病毒感染者肺癌筛查的共同决策？决策冲突，和可接受性？
方法：这是一项单臂试点试验，对40名符合肺癌筛查条件的HIV患者进行决策辅助。决策援助包括个性化筛查建议和艾滋病毒特异性，肺癌和全因死亡率的五年风险估计。参与者在共享决策访问中审查了决策援助，并完成了访问前和访问后的调查，其中包括有关肺癌筛查的知识。可接受性,和决策冲突。
结果：40名参与者的年龄中位数为62岁，60％目前吸烟，5年肺癌风险中位数为2.0％（IQR1.4-3.3％）和4.1％（IQR3.3-7.9％）。个性化建议包括53％的参与者的“鼓励筛查”和其余的“偏好敏感”建议。参与者在两个有效的知识测量中表现出改善，LCS-12的相对改善为60％（p<0.001），LKS-7的相对改善为27％（p<0.001），在有关假阳性和假阴性的问题上有显着改善。偶然发现，肺癌特异性死亡率获益，以及筛查可能的危害。参与者在决策冲突量表上得分较低（中位数为0，IQR为0-5），可接受性较高。90%的人最终在访问后的一个月内接受了筛查。
结论：这种适应艾滋病毒和个人定制的决策帮助提高了参与者的风险知识，好处,筛选具有决策冲突低、可接受性高的特点。这种决策辅助可以在这个高风险人群中实现高质量的共享决策。
