Quality of Shared Decision Making in Lung Cancer Screening: The Right Process, With the Right Partners, at the Right Time and Place

[Extract] When lung cancer screening with
low-dose computed tomography
(LDCT) was added as a Medicare
benefit in 2015, a lung cancer screening counseling and shared decision making (SDM) visit
before the initial screen was made a condition
for reimbursement. It was specified that SDM
should involve the use of decision aids and the
discussion of benefits and harms of proceeding
or not with screening (eg, false-positive findings
leading to unnecessary invasive investigations,
overdiagnosis, and radiation exposure).1 To be
eligible for reimbursement, a clinician (either a
physician or a qualified nonphysician practitioner, eg, a physician assistant, nurse practitioner, or clinical nurse specialist) needs to
conduct the consultation