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.

Public Health Relevance

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 can detect lung cancer early and reduce lung cancer deaths among patients with a history of heavy smoking, but this test requires patients and their physicians to carefully 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.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
1R18HS026198-01A1
Application #
9793912
Study Section
Healthcare Information Technology Research (HITR)
Program Officer
Gamache, Roland
Project Start
2019-07-01
Project End
2022-04-30
Budget Start
2019-07-01
Budget End
2020-04-30
Support Year
1
Fiscal Year
2019
Total Cost
Indirect Cost
Name
University of Utah
Department
Miscellaneous
Type
Schools of Medicine
DUNS #
009095365
City
Salt Lake City
State
UT
Country
United States
Zip Code
84112