{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T13:15:37Z","timestamp":1793020537094,"version":"4.5.0"},"reference-count":43,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T00:00:00Z","timestamp":1720656000000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,6,26]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this systematic review was to explore the evidence regarding shared decision-making (SDM) in the management of pulmonary nodules.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review of quantitative and qualitative studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data source<\/jats:title>\n                    <jats:p>Studies published in English or Chinese up to April 2022 were extracted from nine databases: PubMed, PsycINFO, EMBASE, Cochrane Library, Web of Science and CINAHL, China National Knowledge Infrastructure, Wanfang Data and SinoMed Data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria<\/jats:title>\n                    <jats:p>Studies were eligible if patients or healthcare providers are faced with pulmonary nodule management options or the interventions or experiences were focused on the patient\u2013healthcare provider relationship or health education to make, increase or support shared decisions. All types of studies were included, including quantitative and qualitative studies. Grey literature and literature that had not been peer reviewed were excluded. Poster abstracts and non-empirical publications such as editorials, letters, opinion papers and review articles were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction and synthesis<\/jats:title>\n                    <jats:p>Two reviewers independently screened abstracts and full texts, assessed quality using Joanna Briggs Institute\u2019s critical appraisal tools, and extracted data from included studies. Thematic syntheses were used to identify prominent themes emerging from the data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 12 studies met the inclusion criteria, 11 of which were conducted in USA. These included six qualitative studies and six quantitative studies (including both survey and quasi-experimental designs). Three major themes with specific subthemes emerged: (1) Opportunity (uncertainty in the diagnosis and treatment of pulmonary nodules, willingness to participate in decision-making); (2) Ability (patient\u2019s lack of knowledge, physician\u2019s experience); and (3) Different worldview (misconception, distress among patients, preference for diagnosis and treatment).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Uncertainty in the management of pulmonary nodules is the opportunity to implement SDM. Patients\u2019 lack of knowledge, distress, and misunderstandings between healthcare providers and patients are both the main obstacles and the causes of the application of SDM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-079080","type":"journal-article","created":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T20:05:32Z","timestamp":1720728332000},"page":"e079080","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Shared decision-making in the management of pulmonary nodules: a systematic review of quantitative and qualitative studies"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4671-2794","authenticated-orcid":false,"given":"Jingmin","family":"Yuan","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine, Health Science Center, Yangtze University, Jingzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenglin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Nursing, Hubei College of Chinese Medicine, Jingzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Xi\u2019an Jiaotong University, Xi\u2019an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Xi\u2019an Jiaotong University, Xi\u2019an, China"},{"name":"Department of Talent Highland, The First Affiliated Hospital of Xi\u2019an Jiaotong University, Xi\u2019an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingwei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Xi\u2019an Jiaotong University, Xi\u2019an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sifang","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,11]]},"reference":[{"key":"2025120518171953000_14.7.e079080.1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1164\/rccm.1937P11","article-title":"What is a lung Nodule?","volume":"193","author":"Slatore","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"2025120518171953000_14.7.e079080.2","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/j.chest.2020.02.007","article-title":"Patient-centered, guideline-concordant discussion and management of pulmonary nodules","volume":"158","author":"Wiener","year":"2020","journal-title":"Chest"},{"key":"2025120518171953000_14.7.e079080.3","unstructured":"International Agency for Research on Cancer . Thoracic tumors. Lyon Cedex: International Agency for Research on Cancer, 2021."},{"key":"2025120518171953000_14.7.e079080.4","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jtho.2021.09.017","article-title":"Introduction to 2021 WHO classification of Thoracic tumors","volume":"17","author":"Tsao","year":"2022","journal-title":"J Thorac Oncol"},{"key":"2025120518171953000_14.7.e079080.5","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1016\/j.chest.2017.10.013","article-title":"Pulmonary nodules: A small problem for many, severe distress for some, and how to communicate about it","volume":"153","author":"Slatore","year":"2018","journal-title":"Chest"},{"key":"2025120518171953000_14.7.e079080.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.02.650"},{"key":"2025120518171953000_14.7.e079080.7","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.rmed.2015.01.007","article-title":"Decision making among veterans with incidental pulmonary nodules: a qualitative analysis","volume":"109","author":"Slatore","year":"2015","journal-title":"Respir Med"},{"key":"2025120518171953000_14.7.e079080.8","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1513\/AnnalsATS.201304-080OC","article-title":"\u201cWhat the Heck is a \"Nodule\"? A qualitative study of veterans with pulmonary nodules\u201d","volume":"10","author":"Slatore","year":"2013","journal-title":"Ann Am Thorac Soc"},{"key":"2025120518171953000_14.7.e079080.9","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1513\/AnnalsATS.201609-727OC","article-title":"Clinical Equipoise and shared decision-making in pulmonary Nodule management. A survey of American Thoracic society Clinicians","volume":"14","author":"Iaccarino","year":"2017","journal-title":"Ann Am Thorac Soc"},{"key":"2025120518171953000_14.7.e079080.10","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1016\/j.acra.2018.01.012","article-title":"Modified lung-RADS improves performance of screening LDCT in a population with high prevalence of non-smoking-related lung cancer","volume":"25","author":"Hsu","year":"2018","journal-title":"Acad Radiol"},{"key":"2025120518171953000_14.7.e079080.11","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1016\/j.cllc.2016.03.004","article-title":"Assessment of selection criteria for low-dose lung screening CT among Asian ethnic groups in Taiwan: from mass screening to specific risk-based screening for non-smoker lung cancer","volume":"17","author":"Wu","year":"2016","journal-title":"Clin Lung Cancer"},{"key":"2025120518171953000_14.7.e079080.12","doi-asserted-by":"crossref","first-page":"3466","DOI":"10.1016\/j.pec.2022.09.005","article-title":"The mediating role of decision-making conflict in the association between patient\u2019s participation satisfaction and distress during medical decision-making among Chinese patients with pulmonary nodules","volume":"105","author":"Yuan","year":"2022","journal-title":"Patient Educ Couns"},{"key":"2025120518171953000_14.7.e079080.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(00)00098-8"},{"key":"2025120518171953000_14.7.e079080.14","doi-asserted-by":"crossref","first-page":"1983","DOI":"10.1513\/AnnalsATS.201607-555OC","article-title":"Longitudinal assessment of distress among veterans with incidental pulmonary nodules","volume":"13","author":"Slatore","year":"2016","journal-title":"Annals ATS"},{"key":"2025120518171953000_14.7.e079080.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2008.12.006"},{"key":"2025120518171953000_14.7.e079080.16","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-032013-182440"},{"key":"2025120518171953000_14.7.e079080.17","doi-asserted-by":"crossref","first-page":"104100","DOI":"10.1016\/j.ijnurstu.2021.104100","article-title":"The evidence base of nurse-led family interventions for improving family outcomes in adult critical care settings: A mixed method systematic review","volume":"125","author":"Kiwanuka","year":"2022","journal-title":"Int J Nurs Stud"},{"key":"2025120518171953000_14.7.e079080.18","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"2025120518171953000_14.7.e079080.19","doi-asserted-by":"publisher","DOI":"10.1177\/1049732312452938"},{"key":"2025120518171953000_14.7.e079080.20","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1016\/j.athoracsur.2021.04.094","article-title":"Strategies for the management of solitary pulmonary nodules: a survey of patient preferences","volume":"113","author":"Smith","year":"2022","journal-title":"Ann Thorac Surg"},{"key":"2025120518171953000_14.7.e079080.21","unstructured":"Bowman M , Skabelund AJ . The effect of a pulmonary Nodule Factsheet on patient anxiety and knowledge: a quality improvement initiative. Am J Respir Crit Care Med 2017;195. Available: https:\/\/doi.org\/10.1164\/ajrccm-conference.2017.B110"},{"key":"2025120518171953000_14.7.e079080.22","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1016\/j.chest.2020.03.081","article-title":"Patient vs clinician perspectives on communication about results of lung cancer screening: a qualitative study","volume":"158","author":"Wiener","year":"2020","journal-title":"Chest"},{"key":"2025120518171953000_14.7.e079080.23","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1378\/chest.14-2941","article-title":"Pulmonologists' reported use of guidelines and shared decision-making in evaluation of pulmonary nodules: a qualitative study","volume":"148","author":"Wiener","year":"2015","journal-title":"Chest"},{"key":"2025120518171953000_14.7.e079080.24","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2012.1078"},{"key":"2025120518171953000_14.7.e079080.25","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1109283"},{"key":"2025120518171953000_14.7.e079080.26","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.jtho.2016.01.018","article-title":"Patients' knowledge, beliefs, and distress associated with detection and evaluation of incidental pulmonary nodules for cancer: results from a multicenter survey","volume":"11","author":"Freiman","year":"2016","journal-title":"J Thorac Oncol"},{"key":"2025120518171953000_14.7.e079080.27","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-1095"},{"key":"2025120518171953000_14.7.e079080.28","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1378\/chest.14-2938","article-title":"Primary care providers and a system problem: a qualitative study of clinicians caring for patients with incidental pulmonary nodules","volume":"148","author":"Golden","year":"2015","journal-title":"Chest"},{"key":"2025120518171953000_14.7.e079080.29","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1513\/AnnalsATS.201511-745OC","article-title":"Patient and clinician characteristics associated with adherence: a cohort study of veterans with incidental pulmonary nodules","volume":"13","author":"Moseson","year":"2016","journal-title":"Annals ATS"},{"key":"2025120518171953000_14.7.e079080.30","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201406-283OC"},{"key":"2025120518171953000_14.7.e079080.31","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201104-0679CI"},{"key":"2025120518171953000_14.7.e079080.32","doi-asserted-by":"crossref","DOI":"10.1183\/16000617.0288-2020","article-title":"Contemporary issues in the implementation of lung cancer screening","volume":"30","author":"Lam","year":"2021","journal-title":"Eur Respir Rev"},{"key":"2025120518171953000_14.7.e079080.33","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00186212"},{"key":"2025120518171953000_14.7.e079080.34","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.chest.2017.03.009","article-title":"Pulmonary Nodule guidelines: what physicians do when evidence-based guidelines lack high-quality evidence","volume":"152","year":"2017","journal-title":"Chest"},{"key":"2025120518171953000_14.7.e079080.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2008.07.018"},{"key":"2025120518171953000_14.7.e079080.36","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1016\/j.jval.2021.03.011","article-title":"Influence of shared decision making on decisional conflict and regret in postpartum mother-infant care: A randomized controlled trial","volume":"24","author":"Wang","year":"2021","journal-title":"Value Health"},{"key":"2025120518171953000_14.7.e079080.37","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1001\/jamainternmed.2017.8713","article-title":"Effectiveness of an intervention supporting shared decision making for destination therapy left ventricular assist device","volume":"178","author":"Allen","year":"2018","journal-title":"JAMA Intern Med"},{"key":"2025120518171953000_14.7.e079080.38","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s40257-018-0390-5","article-title":"Shared decision making in psoriasis: A systematic review of quantitative and qualitative studies","volume":"20","author":"Larsen","year":"2019","journal-title":"Am J Clin Dermatol"},{"key":"2025120518171953000_14.7.e079080.39","doi-asserted-by":"publisher","DOI":"10.1002\/nur.20176"},{"key":"2025120518171953000_14.7.e079080.40","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2015-207168"},{"key":"2025120518171953000_14.7.e079080.41","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1188\/13.CJON.525-531","article-title":"Foundations for lung Nodule management for nurse navigators","volume":"17","author":"Hunnibell","year":"2013","journal-title":"Clin J Oncol Nurs"},{"key":"2025120518171953000_14.7.e079080.42","doi-asserted-by":"crossref","unstructured":"O\u2019Brien F , Valentine L , Telford C . An assessment of nurse led follow up of pulmonary nodules. Eur Respir J 2016;48. doi:10.1183\/13993003.congress-2016.PA3080","DOI":"10.1183\/13993003.congress-2016.PA3080"},{"key":"2025120518171953000_14.7.e079080.43","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.12.057"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-079080","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T02:17:31Z","timestamp":1764987451000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-079080"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":43,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7,11]]},"published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1136\/bmjopen-2023-079080"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-079080","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7]]}}}