Despite proclamations to the contrary, it’s likely that the next wave of technologies to hit healthcare are likely to aid decision making of patients and clinicians rather than replace them.  A good example comes via a recent study, which was published in the Annals of Internal Medicine and forms the basis of a new online decision support tool that will help to personalize the lung cancer screening process.

The tool, which goes by the catchy title of Lung Decision Precision, aims to help clinicians talk with patients about whether or not they should get a lung CT scan.  The aim is to provide easy to understand support to help them navigate things at what is a very difficult time.

“Our model is built on a comprehensive view of net benefits for individual patients, which incorporates the best evidence for personalizing the pros and cons of screening and assumes that not all patients will feel the same about screening and its consequences,” the team say.  “This allows us to identify which patients are in the preference-sensitive zone for the decision about screening, and which ones have a very clear potential benefit to them.”

Decision support

It’s widely believed that people with an annual change of developing lung cancer of between 0.3% and 1.3% are good candidates for screening.  This currently accounts for around 50% of people who qualify for it under current guidelines.  The team believe that the tool can help the physician customize the conversation they have with patients in real time.

“If a physician is not clear about the potential benefit for a patient who’s in the high-benefit zone, they could miss an opportunity to do something really good for them, to say, ‘I don’t recommend this for everyone but I recommend it for you,’” the team explain. “But coming across strong for screening with a patient who has a fine balance of pros and cons could miss an opportunity to give them a choice, to tell them that their decision depends on the kind of person they are.”

It’s an approach the team believe could be equally valuable for a range of other conditions.  They focused on lung cancer because of recent initiatives to encourage smokers between 55 and 80 to get screened for the disease.  This recommendation is off the back of research suggesting the boost such early screening could provide to survival chances, but the recommendations are not blanket.  They do specify that screening should only apply to those with an expected life expectancy of over 10 years.

The team are continuing to work, both to better understand how the tool is used by physicians and also to gauge whether it can be implemented into online systems that patients use to communicate with their health clinic prior to their appointment.  In other words, they’re exploring how it can be better integrated into the workflow.