Responsiveness of a Brief Measure of Lung Cancer Screening Knowledge

• Published in: Journal of cancer education Vol. 33; no. 4; pp. 842 - 846
• Main Authors: Housten, Ashley J., Lowenstein, Lisa M., Leal, Viola B., Volk, Robert J.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-08-2018; Springer Nature B.V
• Subjects: Biomedical and Life Sciences; Biomedicine; Cancer; Cancer Research; Clinical decision making; Decision Making; Decision Support Techniques; Early Detection of Cancer - psychology; Early Detection of Cancer - statistics & numerical data; Effect Size; Female; Health Knowledge, Attitudes, Practice; Humans; Lung cancer; Lung Neoplasms - diagnosis; Lung Neoplasms - psychology; Male; Medical screening; Middle Aged; Outcome Assessment, Health Care; Outcome Measures; Pharmacology/Toxicology; Surveys and Questionnaires; Tomography; Shared decision making; Knowledge measure; Lung cancer screening; Smoking
• ISSN: 0885-8195; 1543-0154
• DOI: 10.1007/s13187-016-1153-8

Our aim was to examine the responsiveness of a lung cancer screening brief knowledge measure (LCS-12). Eligible participants were aged 55–80 years, current smokers or had quit within 15 years, and English speaking. They completed a baseline pretest survey, viewed a lung cancer screening video-based patient decision aid, and then filled out a follow-up posttest survey. We performed a paired samples
t
-test, calculated effect size, and calculated absolute and relative percent improvement for each item. Participants (
n
 = 30) were primarily White (63%) with less than a college degree (63%), and half were female (50%). Mean age was 61.5 years (standard deviation [SD] = 4.67) and average smoking history was 30.4 pack-years (range = 4.6–90.0). Mean score on the 12-item measure increased from 47.3% correct on the pretest to 80.3% correct on the posttest (mean pretest score = 5.67 vs. mean posttest score = 9.63; mean score difference = 3.97, SD = 2.87, 95% CI = 2.90, 5.04). Total knowledge scores improved significantly and were responsive to the decision aid intervention (paired samples
t
-test = 7.57,
p
 < .001; Cohen’s effect size = 1.59; standard response mean [SRM] = 1.38). All individual items were responsive, yet two items had lower absolute responsiveness than the others (item 8: “Without screening, is lung cancer often found at a later stage when cure is less likely?” pretest correct = 83.3% vs. posttest = 96.7%, responsiveness = 13.4%; and item 10: “Can a CT scan find lung disease that is not cancer?” pretest correct = 80.0% vs. posttest = 93.3%, responsiveness = 13.3%). The LCS-12 knowledge measure may be a useful outcome measure of shared decision making for lung cancer screening.