肺癌筛查（LCS）建议在共享决策对话后，对年龄和吸烟史高风险的个体进行筛查。然而，对于如何在繁忙的初级护理环境中整合共享决策的最佳策略知之甚少。为了开发一种新颖工具，肺癌风险评估与教育（LungCARE），以指导符合条件的初级护理患者做出LCS决策。肺CARE与常规护理进行了一项先导集群随机对照试验。试验对象是符合LCS条件的大学初级护理诊所的患者。提供者被随机分配到LungCARE干预组和对照组。LungCARE参与者在初级护理就诊前在等候室里完成了基于计算机平板的肺癌教育需求视频评估。患者和提供者都收到了患者关注和回应的摘要传单。所有符合条件的患者通过电话完成了基线访谈。首次就诊后一周，参与者通过电话完成了一次后续调查，该调查评估了LCS的患者-医生讨论、转诊和安排，以及LCS知识和LungCARE的可接受程度。首次就诊后两个月，我们查阅了患者的电子医疗记录（EHR），以了解共享决策对话和转诊以及接受LCS的证据。共有66名参与者完成了基线和后续访问（34名LungCARE组；32名常规护理组）。平均年龄为65.9岁（±6.0）。基于EHR的回顾显示，与常规护理相比，LungCARE参与者更有可能与其医生讨论LCS（56%对25%；p=0.04），并接受LCS转诊（44%对13%；p<0.02）。干预组参与者还更有可能完成LCS（32%对13%；p<0.01），并且LCS知识得分更高（平均分数6.5（±1.7）对5.5（±1.4）；p<0.01）。LungCARE增加了LCS的讨论、转诊和完成，并提高了LCS的知识水平。NCT03862001.© 2023. 作者（们）。

Lung cancer screening (LCS) is recommended for individuals at high risk due to age and smoking history after a shared decision-making conversation. However, little is known about best strategies for incorporating shared decision-making, especially in a busy primary care setting.To develop a novel tool, Lung Cancer Assessment of Risk and Education (LungCARE) to guide LCS decisions among eligible primary care patients.Pilot cluster randomized controlled trial of LungCARE versus usual care.Patients of providers in a university primary care clinic, who met criteria for LCS.Providers were randomized to LungCARE intervention or control. LungCARE participants completed a computer tablet-based video assessment of lung cancer educational needs in the waiting room prior to a primary care visit. Patient and provider both received a summary handout of patient concerns and responses.All eligible patients completed baseline interviews by telephone. One week after the index visit, participants completed a follow-up telephone survey that assessed patient-physician discussion of LCS, referral to and scheduling of LCS, as well as LCS knowledge and acceptability of LungCARE. Two months after index visit, we reviewed patients' electronic health records (EHRs) for evidence of a shared decision-making conversation and referral to and receipt of LCS.A total of 66 participants completed baseline and follow-up visits (34: LungCARE; 32: usual care). Mean age was 65.9 (± 6.0). Based on EHR review, compared to usual care, LungCARE participants were more likely to have discussed LCS with their physicians (56% vs 25%; p = 0.04) and to be referred to LCS (44% vs 13%; p < 0.02). Intervention participants were also more likely to complete LCS (32% vs 13%; p < 0.01) and had higher knowledge scores (mean score 6.5 (± 1.7) vs 5.5 (± 1.4; p < 0.01).LungCARE increased discussion, referral, and completion of LCS and improved LCS knowledge.NCT03862001.© 2023. The Author(s).