Stakeholder Research Priorities to Promote Implementation of Shared Decision-Making for Lung Cancer Screening: An American Thoracic Society and Veterans Affairs Health Services Research and Development Statement
Renda Soylemez Wiener, Anna M. Barker, Lisa Carter-Harris, Tanner J. Caverly, David A. Crocker, Angela Denietolis, Charlotte Doherty, Angela Fagerlin, Mary Gallagher-Seaman, Michael K. Gould, Paul K. J. Han, Abigail N. Herbst, Mayuko Ito Fukunaga, Megan B. McCullough, Danielle A. Miano, Samantha L. Quaife, Christopher G. Slatore, Gemmae M. Fix
Abstract
Abstract Rationale Shared decision-making (SDM) for lung cancer screening (LCS) is recommended in guidelines and required by Medicare, yet it is seldom achieved in practice. The best approach for implementing SDM for LCS remains unknown, and the 2021 U.S. Preventive Services Task Force calls for implementation research to increase uptake of SDM for LCS. Objectives To develop a stakeholder-prioritized research agenda and recommended outcomes to advance implementation of SDM for LCS. Methods The American Thoracic Society and VA Health Services Research and Development Service convened a multistakeholder committee with expertise in SDM, LCS, patient-centered care, and implementation science. During a virtual State of the Art conference, we reviewed evidence and identified research questions to address barriers to implementing SDM for LCS, as well as outcome constructs, which were refined by writing group members. Our committee (n = 34) then ranked research questions and SDM effectiveness outcomes by perceived importance in an online survey. Results We present our committee’s consensus on three topics important to implementing SDM for LCS: 1) foundational principles for the best practice of SDM for LCS; 2) stakeholder rankings of 22 implementation research questions; and 3) recommended outcomes, including Proctor’s implementation outcomes and stakeholder rankings of SDM effectiveness outcomes for hybrid implementation–effectiveness studies. Our committee ranked questions that apply innovative implementation approaches to relieve primary care providers of the sole responsibility of SDM for LCS as highest priority. We rated effectiveness constructs that capture the patient experience of SDM as most important. Conclusions This statement offers a stakeholder-prioritized research agenda and outcomes to advance implementation of SDM for LCS.