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Comment & Response
November 2015

Shared Decision-Making for Cancer Screening: Visual Tools and a 4-Step Method

Author Affiliations
  • 1Amiens University Hospital, 80000 Amiens, France
  • 2Women's Health Academic Centre, St Thomas' Hospital, London, England
JAMA Intern Med. 2015;175(11):1862. doi:10.1001/jamainternmed.2015.4721

To the Editor Caverly’s concerns for promoting shared decision-making and selecting the best candidates for lung cancer screening deserve comment.1

First, it is untrue that developing a shared decision-making tool is complex.1 Common sense pictographs that use absolute numbers with a consistent denominator (ie, /1000 screened), time frames, and visuals employing the same scale for information on gains and losses of the options have been shown to change and improve decision-making.2,3 Such pictographs for breast cancer screening are already implemented in the small country of Belgium.4 It is puzzling why national health care agencies from so many countries enduringly fail to do this job properly.

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