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Ann Am Thorac Soc. 2017 Oct;14(10):1581-1590. doi: 10.1513/AnnalsATS.201705-378SD.

Rationale and Design of the Lung Cancer Screening Implementation. Evaluation of Patient-Centered Care Study.

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1 Health Services Research and Development, and.
2 Division of General Internal Medicine.
3 Minneapolis VA Health Care System, Minneapolis, Minnesota.
4 Center for Chronic Disease Outcomes Research, Minneapolis, Minnesota.
5 Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial VA Hospital, Bedford, Massachusetts.
6 The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts.
7 Duke Center for Smoking Cessation, and.
9 Duke Regional Hospital, Duke University, Durham, North Carolina.
8 Duke Smoking Cessation Program, The Duke Cancer Institute at Duke University, Durham, North Carolina.
10 Department of Surgery, Duke University Medical Center, Durham, North Carolina; and.
12 Section of Pulmonary and Critical Care Medicine, Veterans Affairs (VA) Portland Health Care System, Portland, Oregon.
11 Department of Medicine, Oregon Health and Science University, Portland, Oregon.


Screening for lung cancer using low-dose computed tomography has been demonstrated to reduce lung cancer-related mortality and is being widely implemented. Further research in this area is needed to assess the impact of screening on patient-centered outcomes. Here, we describe the design and rationale for a new study entitled Lung Cancer Screening Implementation: Evaluation of Patient-Centered Care. The protocol is composed of an interconnected series of studies evaluating patients and clinicians who are engaged in lung cancer screening in real-world settings. The primary goal of this study is to evaluate communication processes that are being used in routine care and to identify best practices that can be readily scaled up for implementation in multiple settings. We hypothesize that higher overall quality of patient-clinician communication processes will be associated with lower levels of distress and decisional conflict as patients decide whether or not to participate in lung cancer screening. This work is a critical step toward identifying modifiable mechanisms that are associated with high quality of care for the millions of patients who will consider lung cancer screening. Given the enormous potential benefits and burdens of lung cancer screening on patients, clinicians, and the healthcare system, it is important to identify and then scale up quality communication practices that positively influence patient-centered care.


lung cancer screening; patient-centered outcomes research; patient–clinician communication

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