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25.01.2018 | original article | Ausgabe 7-8/2018

Wiener klinische Wochenschrift 7-8/2018

Do doctors understand the test characteristics of lung cancer screening?

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 7-8/2018
Autoren:
Richard Schmidt, Marie Breyer, Robab Breyer-Kohansal, Matthias Urban, Georg-Christian Funk
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00508-017-1305-9) contains supplementary material, which is available to authorized users.

Summary

Background

Screening for lung cancer with a low-dose computed tomography (CT) scan is estimated to prevent 3 deaths per 1000 individuals at high risk; however, false positive results and radiation exposure are relevant harms and deserve careful consideration. Screening candidates can only make an autonomous decision if doctors correctly inform them of the pros and cons of the method; therefore, this study aimed to evaluate whether doctors understand the test characteristics of lung cancer screening.

Methods

In a randomized trial 556 doctors (members of the Austrian Respiratory Society) were invited to answer questions regarding lung cancer screening based on online case vignettes. Half of the participants were randomized to the group ‘solutions provided’ and received the correct solutions in advance. The group ‘solutions withheld’ had to rely on prior knowledge or estimates. The primary endpoint was the between-group difference in the estimated number of deaths preventable by screening. Secondary endpoints were the between-group differences in the prevalence of lung cancer, prevalence of a positive screening results, sensitivity, specificity, positive predictive value, and false negative rate. Estimations were also compared with current data from the literature.

Results

The response rate was 29% in both groups. The reduction in the number of deaths due to screening was overestimated six-fold (95% confidence interval CI: 4–8) compared with the actual data, and there was no effect of group allocation. Providing the correct solutions to doctors had no systematic effect on their answers.

Conclusion

Doctors poorly understand the test characteristics of lung cancer screening. Providing the correct solutions in advance did not improve the answers. Continuing education regarding lung cancer screening and the interpretation of test characteristics may be a simple remedy.

Clinical trial registration

Clinical trial registered with www.​clinicaltrials.​gov (NCT02542332).

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Zusatzmaterial
The following e‑mail invitation was sent to all participants (the following electronic supplemental material)
508_2017_1305_MOESM1_ESM.docx
After clicking on the link “Start Survey”, the members of the group ‘solutions withheld’ received the following instructions (the following electronic supplemental material)
508_2017_1305_MOESM2_ESM.docx
After clicking on the link “Start Survey”, the members of the group ‘solutions provided’ received the following instructions and study data (electronic supplemental material).
508_2017_1305_MOESM3_ESM.docx
Literatur
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