ASPO Abstracts
Significance of a Shared Decision-Making Consultation on Lung Cancer Screening Efficacy
Category: Early Detection & Risk Prediction
Conference Year: 2022
Abstract Body:
Purpose of the study: To determine whether documentation of a shared decision-making (SDM) consultation is associated with subsequent adherence to annual lung cancer screening (LCS).Methods: Data was obtained from the Colorado All Payer Claims Dataset (Co-APCD), which contains insurance claims data for the majority of insured lives in Colorado. The extracted dataset included all health claims, procedural codes, and dates of services from 1/1/2012 to 12/31/2018 for individuals with claims for LCS specific low dose CTs (LDCT), using codes S8032 and G0297. Annual adherence was defined as having a second LDCT claim within 15 months of the index LDCT by calculating time between dates of the index LDCT claim and the next subsequent LDCT claim available in the dataset. The analysis was limited to individuals with a complete 15 months of follow-up time available in the CO APCD dataset. Individuals with a SDM claim within 90 days preceding the index LDCT (G0296) were classified as having a documented SDM consultation. Multivariate logistic regression was used to examine the relationship between a SDM consultation claim and annual adherence.Results: After excluding duplicate LDCT claims, individuals with <15 months of follow-up time, individuals with lung cancer diagnoses, individuals <55 or >79 years of age, out of state residents, and records with missing regression model data, the final analytic dataset consisted of 7,193 records with 2,476 adherent and 4,717 non-adherent individuals. The 15-month adherence was 34% and 423 individuals (5.9%) had a SDM claim within 90 days of the index LDCT. After adjustment for sex, age, insurance type, residence (urban/ rural), Charlson Comorbidity Index score, and outpatient healthcare usage over a 5-year period, individuals with a SDM consultation claim had 1.25 (95% CI: 1.01, 1.54) times the odds of being adherent to annual LCS than those without SDM documentation. Conclusions: This analysis shows that documentation of a SDM consultation from claims data is associated with individuals being more likely to be adherent to annual LCS. While the content and adequacy of the SDM conversation cannot be accessed from the CO APCD, any increase in adherence helps optimize the individual and population health benefits of LCS.
Keywords: lung cancer screening, shared decision-making, adherence, claims data