An integrated digital/clinical approach to smoking cessation in lung cancer screening: study protocol for a randomized controlled trial

Amanda L Graham, Michael V Burke, Megan A Jacobs, Sarah Cha, Ivana T Croghan, Darrell R Schroeder, James P Moriarty, Bijan J Borah, Donna F Rasmussen, M Jody Brookover, Dale B Suesse, David E Midthun, J Taylor Hays, Amanda L Graham, Michael V Burke, Megan A Jacobs, Sarah Cha, Ivana T Croghan, Darrell R Schroeder, James P Moriarty, Bijan J Borah, Donna F Rasmussen, M Jody Brookover, Dale B Suesse, David E Midthun, J Taylor Hays

Abstract

Background: Delivering effective tobacco dependence treatment that is feasible within lung cancer screening (LCS) programs is crucial for realizing the health benefits and cost savings of screening. Large-scale trials and systematic reviews have demonstrated that digital cessation interventions (i.e. web-based and text message) are effective, sustainable over the long-term, scalable, and cost-efficient. Use of digital technologies is commonplace among older adults, making this a feasible approach within LCS programs. Use of cessation treatment has been improved with models that proactively connect smokers to treatment rather than passive referrals. Proactive referral to cessation treatment has been advanced through healthcare systems changes such as modifying the electronic health record to automatically link smokers to treatment.

Methods: This study evaluates the impact of a proactive enrollment strategy that links LCS-eligible smokers with an evidence-based intervention comprised of a web-based (WEB) program and integrated text messaging (TXT) in a three-arm randomized trial with repeated measures at one, three, six, and 12 months post randomization. The primary outcome is biochemically confirmed abstinence at 12 months post randomization. We will randomize 1650 smokers who present for a clinical LCS to: (1) a usual care control condition (UC) which consists of Ask-Advise-Refer; (2) a digital (WEB + TXT) cessation intervention; or (3) a digital cessation intervention combined with tobacco treatment specialist (TTS) counseling (WEB + TXT + TTS).

Discussion: The scalability and sustainability of a digital intervention may represent the most cost-effective and feasible approach for LCS programs to proactively engage large numbers of smokers in effective cessation treatment. We will also evaluate the impact and cost-effectiveness of adding proven clinical intervention provided by a TTS. We expect that a combined digital/clinical intervention will yield higher quit rates than digital alone, but that it may not be as cost-effective or feasible for LCS programs to implement. This study is innovative in its use of interoperable, digital technologies to deliver a sustainable, scalable, high-impact cessation intervention and to facilitate its integration within clinical practice. It will add to the growing knowledge base about the overall effectiveness of digital interventions and their role in the healthcare delivery system.

Trial registration: ClinicalTrials.gov, NCT03084835 . Registered on 9 March 2017.

Keywords: Cancer screening; Counseling; Internet; Lung cancer; Smoking cessation; Text messages; Tobacco use cessation.

Conflict of interest statement

Ethics approval and consent to participate

All study participants will provide informed consent. Ethics approval was obtained from Mayo Clinic Institutional Review Board (16-004891).

Consent for publication

Not applicable.

Competing interests

ALG, MAJ, SC, and MJB are employed by Truth Initiative, the organization that runs BecomeAnEX.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
SPIRIT figure
Fig. 2
Fig. 2
Mediational model

References

    1. Ma J, Ward EM, Smith R, Jemal A. Annual number of lung cancer deaths potentially avertable by screening in the United States. Cancer. 2013;119(7):1381–5.
    1. National Lung Screening Trial Research Team. Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395–409.
    1. National Center for Chronic Disease Prevention and Health Promotion Office on Smoking and Health . The health consequences of smoking - 50 years of progress: a report of the Surgeon General. Atlanta: Centers for Disease Control and Prevention; 2014.
    1. Taylor KL, Cox LS, Zincke N, Mehta L, McGuire C, Gelmann E. Lung cancer screening as a teachable moment for smoking cessation. Lung Cancer. 2007;56(1):125–34.
    1. Ostroff JS, Buckshee N, Mancuso CA, Yankelevitz DF, Henschke CI. Smoking cessation following CT screening for early detection of lung cancer. Prev Med. 2001;33(6):613–21.
    1. Townsend CO, Clark MM, Jett JR, Patten CA, Schroeder DR, Nirelli LM, et al. Relation between smoking cessation and receiving results from three annual spiral chest computed tomography scans for lung carcinoma screening. Cancer. 2005;103(10):2154–62.
    1. Schnoll RA, Bradley P, Miller SM, Unger M, Babb J, Cornfeld M. Psychological issues related to the use of spiral CT for lung cancer early detection. Lung Cancer. 2003;39(3):315–25.
    1. Slatore CG, Baumann C, Pappas M, Humphrey LL. Smoking behaviors among patients receiving computed tomography for lung cancer screening. Systematic review in support of the U.S. preventive services task force. Ann Am Thorac Soc. 2014;11(4):619–27.
    1. Goffin JR, Flanagan WM, Miller AB, Fitzgerald NR, Memon S, Wolfson MC, et al. Cost-effectiveness of lung cancer screening in Canada. JAMA Oncol. 2015;1:807–13.
    1. Villanti AC, Jiang Y, Abrams DB, Pyenson BS. A cost-utility analysis of lung cancer screening and the additional benefits of incorporating smoking cessation interventions. PLoS One. 2013;8(8):e71379.
    1. Midthun DE, Jett JR. Screening for lung cancer: the US studies. J Surg Oncol. 2013;108(5):275–9.
    1. Midthun DE. Early diagnosis of lung cancer. F1000Prime Rep. 2013;5:12.
    1. Jensen TS, Chin J, Ashby L, Hermansen J, Hutter JD. Final national coverage determination on screening for lung cancer with low dose computed tomography (LDCT) Baltimore: Centers for Medicare and Medicaid Services; 2015.
    1. Ostroff JS, Copeland A, Borderud SP, Li Y, Shelley DR, Henschke CI. Readiness of lung cancer screening sites to deliver smoking cessation treatment: current practices, organizational priority, and perceived barriers. Nicotine Tob Res. 2016;18(5):1067–75.
    1. Bentz CJ, Bayley KB, Bonin KE, Fleming L, Hollis JF, McAfee T. The feasibility of connecting physician offices to a state-level tobacco quit line. Am J Prev Med. 2006;30(1):31–7.
    1. Katz DA, Muehlenbruch DR, Brown RB, Fiore MC, Baker TB, Smoking Cessation Guideline Study Group AHRQ. Effectiveness of a clinic-based strategy for implementing the AHRQ Smoking Cessation Guideline in primary care. Prev Med. 2002;35(3):293–301.
    1. Solberg LI, Maciosek MV, Edwards NM, Khanchandani HS, Goodman MJ. Repeated tobacco-use screening and intervention in clinical practice: health impact and cost effectiveness. Am J Prev Med. 2006;31(1):62–71.
    1. Borland R, Segan CJ. The potential of quitlines to increase smoking cessation. Drug Alcohol Rev. 2006;25(1):73–8.
    1. Fucito LM, Czabafy S, Hendricks PS, Kotsen C, Richardson D, Toll BA, et al. Pairing smoking-cessation services with lung cancer screening: A clinical guideline from the Association for the Treatment of Tobacco Use and Dependence and the Society for Research on Nicotine and Tobacco. Cancer. 2016;122(8):1150–9.
    1. Sisterhen LL, Sheffer CE, Bursac Z, Fischer EP. Rates of enrollment in smoking cessation services following fax referrals from a children’s hospital. Acad Pediatr. 2010;10(3):200–4.
    1. Willett JG, Hood NE, Burns EK, Swetlick JL, Wilson SM, Lang DA, et al. Clinical faxed referrals to a tobacco quitline: reach, enrollment, and participant characteristics. Am J Prev Med. 2009;36(4):337–40.
    1. Zarling KK, Burke MV, Gaines KA, Gauvin TR. Registered nurse initiation of a tobacco intervention protocol: leading quality care. J Cardiovasc Nurs. 2008;23(5):443–8.
    1. Adsit RT, Fox BM, Tsiolis T, Ogland C, Simerson M, Vind LM, et al. Using the electronic health record to connect primary care patients to evidence-based telephonic tobacco quitline services: a closed-loop demonstration project. Transl Behav Med. 2014;4(3):324–32.
    1. Warren GW, Marshall JR, Cummings KM, Zevon MA, Reed R, Hysert P, et al. Automated tobacco assessment and cessation support for cancer patients. Cancer. 2014;120(4):562–9.
    1. Vidrine JI, Shete S, Cao Y, Greisinger A, Harmonson P, Sharp B, et al. Ask-Advise-Connect: a new approach to smoking treatment delivery in health care settings. JAMA Int Med. 2013;173(6):458–64.
    1. Vidrine JI, Shete S, Li Y, Cao Y, Alford MH, Galindo-Talton RM, et al. The ask–advise–connect approach for smokers in a safety net healthcare system: A group-randomized trial. Am J Prev Med. 2013;45(6):737–41.
    1. Pineiro B, Simmons VN, Palmer AM, Correa JB, Brandon TH. Smoking cessation interventions within the context of low-dose computed tomography lung cancer screening: A systematic review. Lung Cancer. 2016;98:91.
    1. Muñoz RF, Barrera AZ, Delucchi K, Penilla C, Torres LD, Perez-Stable EJ. International Spanish/English Internet smoking cessation trial yields 20% abstinence rates at 1 year. Nicotine Tob Res. 2009;11(9):1025–34.
    1. Graham AL, Cobb NK, Papandonatos GD, Moreno JL, Kang H, Tinkelman DG, et al. A randomized trial of Internet and telephone treatment for smoking cessation. Arch Intern Med. 2011;171(1):46–53.
    1. Civljak M, Stead LF, Hartmann-Boyce J, Sheikh A, Car J. Internet-based interventions for smoking cessation. Cochrane Database Syst Rev. 2013;7:CD007078.
    1. Shahab L, McEwen A. Online support for smoking cessation: a systematic review of the literature. Addiction. 2009;104(11):1792–804.
    1. Hutton HE, Wilson LM, Apelberg BJ, Tang EA, Odelola O, Bass EB, et al. A systematic review of randomized controlled trials: Web-based interventions for smoking cessation among adolescents, college students, and adults. Nicotine Tob Res. 2011;13(4):227–38.
    1. Graham AL, Carpenter KM, Cha S, Cole S, Jacobs MA, Raskob M, et al. Systematic review and meta-analysis of Internet interventions for smoking cessation among adults. Subst Abuse Rehabil. 2016;7:55–69.
    1. Graham AL, Chang Y, Fang Y, Cobb NK, Tinkelman DS, Niaura RS, et al. Cost-effectiveness of internet and telephone treatment for smoking cessation: an economic evaluation of The iQUITT Study. Tob Control. 2013;22(6):e11.
    1. An LC, Betzner A, Schillo B, Luxenberg MG, Christenson M, Wendling A, et al. The comparative effectiveness of clinic, work-site, phone, and Web-based tobacco treatment programs. Nicotine Tob Res. 2010;12(10):989–96.
    1. Bock B, Graham A, Sciamanna C, Krishnamoorthy J, Whiteley J, Carmona-Barros R, et al. Smoking cessation treatment on the Internet: content, quality, and usability. Nicotine Tob Res. 2004;6(2):207–19.
    1. Bock BC, Graham AL, Whiteley JA, Stoddard JL. A review of web-assisted tobacco interventions (WATIs) J Med Internet Res. 2008;10(5):e39.
    1. Cobb NK, Graham AL, Bock BC, Papandonatos G, Abrams DB. Initial evaluation of a real-world Internet smoking cessation system. Nicotine Tob Res. 2005;7(2):207–16.
    1. Ray MN, Funkhouser E, Williams JH, Sadasivam RS, Gilbert GH, Coley HL, et al. Smoking-cessation e-referrals: a national dental practice-based research network randomized controlled trial. Am J Prev Med. 2014;46(2):158–65.
    1. Sadasivam RS, Hogan TP, Volkman JE, Smith BM, Coley HL, Williams JH, et al. Implementing point of care “e-referrals” in 137 clinics to increase access to a quit smoking internet system: the Quit-Primo and National Dental PBRN HI-QUIT Studies. Transl Behav Med. 2013;3(4):370–8.
    1. Gordon JS, Akers L, Severson HH, Danaher BG, Boles SM. Successful participant recruitment strategies for an online smokeless tobacco cessation program. Nicotine Tob Res. 2006;8(Suppl 1):S35–41.
    1. Community Preventive Services Task Force . Reducing tobacco use and secondhand smoke exposure: mobile phone-based cessation interventions. Atlanta, GA: Centers for Disease Control and Prevention; 2011.
    1. Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services; 2008.
    1. Abroms LC, Ahuja M, Kodl Y, Thaweethai L, Sims J, Winickoff JP, et al. Text2Quit: results from a pilot test of a personalized, interactive mobile health smoking cessation program. J Health Comm. 2012;17(Suppl 1):44–53.
    1. Abroms LC, Boal AL, Simmens SJ, Mendel JA, Windsor RA. A randomized trial of Text2Quit: a text messaging program for smoking cessation. Am J Prev Med. 2014;47:242–50.
    1. Brendryen H, Drozd F, Kraft P. A digital smoking cessation program delivered through internet and cell phone without nicotine replacement (happy ending): randomized controlled trial. J Med Internet Res. 2008;10(5):e51.
    1. Brendryen H, Kraft P. Happy ending: a randomized controlled trial of a digital multi-media smoking cessation intervention. Addiction. 2008;103(3):478–84.
    1. Whittaker R, McRobbie H, Bullen C, Rodgers A, Gu Y. Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev. 2016;4:CD006611.
    1. Guerriero C, Cairns J, Roberts I, Rodgers A, Whittaker R, Free C. The cost-effectiveness of smoking cessation support delivered by mobile phone text messaging: Txt2stop. Eur J Health Econ. 2013;14(5):789–97.
    1. Pew Research Center . Internet/Broadband Fact Sheet. Washington, DC: Pew Research Center; 2017.
    1. Medlock S, Eslami S, Askari M, Arts DL, Sent D, de Rooij SE, et al. Health information-seeking behavior of seniors who use the Internet: a survey. J Med Internet Res. 2015;17(1):e10.
    1. Pew Research Center . Mobile fact sheet. Washington, DC: Pew Research Center; 2017.
    1. Care Innovations. Older Populations Have Adopted Technology for Health. Roseville: Care Innovations; 2013. . Accessed 20 Oct 2017.
    1. Bowles KH, Hanlon A, Holland D, Potashnik SL, Topaz M. Impact of discharge planning decision support on time to readmission among older adult medical patients. Prof Case Manag. 2014;19(1):29.
    1. World Health Organization. WHO Global Strategy on People-Centred and Integrated Health Services Interim Report. Geneva: World Health Organization; 2015. . Accessed 20 Oct 2017.
    1. Office of the National Coordinator for Health Information Technology (ONC). Federal Health IT Strategic Plan 2015–2020. Washington, DC: U. S. Department of Health and Human Services; 2015. . Accessed 20 Oct 2017.
    1. Zbikowski SM, Magnusson B, Pockey JR, Tindle HA, Weaver KE. A review of smoking cessation interventions for smokers aged 50 and older. Maturitas. 2012;71(2):131–41.
    1. Shields PG, Herbst RS, Arenberg D, Benowitz NL, Bierut L, Luckart JB, et al. Smoking Cessation, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2016;14(11):1430–68.
    1. Hurt RD, Ebbert JO, Hays JT, McFadden DD. Treating tobacco dependence in a medical setting. CA Cancer J Clin. 2009;59(5):314–26.
    1. Burke MV, Ebbert JO, McFadden D, Hays JT. Treatment outcomes from a specialist model for treating tobacco use disorder in a medical center. Medicine. 2015;94(44):e1903.
    1. Hurt RD, Ebbert JO, Hays JT, McFadden DD. Preventing lung cancer by treating tobacco dependence. Clin Chest Med. 2011;32(4):645–57.
    1. Kotz D, Brown J, West R. Prospective cohort study of the effectiveness of smoking cessation treatments used in the “real world”. Mayo Clin Proc. 2014;89(10):1360–7.
    1. Garces YI, Schroeder DR, Nirelli LM, Croghan GA, Croghan IT, Foote RL, et al. Tobacco use outcomes among patients with head and neck carcinoma treated for nicotine dependence: a matched-pair analysis. Cancer. 2004;101(1):116–24.
    1. Khara M, Okoli C, Nagarajan VD, Aziz F, Hanley C. Smoking cessation outcomes of referral to a specialist hospital outpatient clinic. Am J Addict. 2015;24(6):561–70.
    1. Hughes JR. Tobacco treatment specialists: a new profession. J Smoking Cessation. 2007;2:2–7.
    1. Song F, Maskrey V, Blyth A, Brown TJ, Barton GR, Aveyard P, et al. Differences in longer-term smoking abstinence after treatment by specialist or nonspecialist advisors: secondary analysis of data from a relapse prevention trial. Nicotine Tob Res. 2016;18:1061–6.
    1. Ferketich AK, Otterson GA, King M, Hall N, Browning KK, Wewers ME. A pilot test of a combined tobacco dependence treatment and lung cancer screening program. Lung Cancer. 2012;76(2):211–5.
    1. Reid RD, Mullen KA, Slovinec D’Angelo ME, Aitken DA, Papadakis S, Haley PM, et al. Smoking cessation for hospitalized smokers: an evaluation of the “Ottawa Model”. Nicotine Tob Res. 2010;12(1):11–8.
    1. Zbikowski SM, Hapgood J, Smucker Barnwell S, McAfee T. Phone and web-based tobacco cessation treatment: real-world utilization patterns and outcomes for 11,000 tobacco users. J Med Internet Res. 2008;10(5):e41.
    1. Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89(9):1322–7.
    1. Tunis SR, Stryer DB, Clancy CM. Practical clinical trials: increasing the value of clinical research for decision making in clinical and health policy. JAMA. 2003;290(12):1624–32.
    1. Moyer VA, Force USPST Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160(5):330–8.
    1. Tammemagi MC, Katki HA, Hocking WG, Church TR, Caporaso N, Kvale PA, et al. Selection criteria for lung-cancer screening. N Engl J Med. 2013;368(8):728–36.
    1. Mayo Foundation for Medical Education and Research . Patient Education: Medications to Help You Stop Using Tobacco. Rochester, MN: Mayo Foundation for Medical Education and Research; 2014.
    1. McCausland KL, Curry LE, Mushro A, Carothers S, Xiao H, Vallone DM. Promoting a web-based smoking cessation intervention: implications for practice. Cases Public Health Commun Mark. 2011;5:3–26.
    1. Richardson A, Graham AL, Cobb N, Xiao H, Mushro A, Abrams D, et al. Engagement promotes abstinence in a web-based cessation intervention: cohort study. J Med Internet Res. 2013;15(1):e14.
    1. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215.
    1. Czaja SJ, Lee CC. Older Adults and Information Technology: Opportunities and Challenges. In: Jacko JA, editor. The Human-Computer Interaction Handbook: Fundamentals, Evolving Technologies and Emerging Applications. Boca Raton: Taylor & Francis; 2012. p. 825-40.
    1. National Institute on Aging: Making Your Website Senior Friendly. 2011. . Accessed 20 Oct 2017.
    1. Arch A, Abou-Zahra S. Web accessibility and older people: meeting the needs of ageing web users. 2010.
    1. Chisnell D, Redish J. Designing web sites for older adults: expert review of 50 web sites. 2004.
    1. Centers for Medicare & Medicaid Services. Decision memo for screening for lung cancer with low dose computed tomography (LDCT) (CAG-00439 N). Baltimore, MD: Centers for Medicare and Medicaid, U.S. Department of Health and Human Services. . Accessed 20 Oct 2017.
    1. Kazerooni EA, Austin JH, Black WC, Dyer DS, Hazelton TR, Leung AN, et al. ACR-STR practice parameter for the performance and reporting of lung cancer screening thoracic computed tomography (CT): 2014 (Resolution 4) J Thorac Imaging. 2014;29(5):310–6.
    1. Shah A, Yon A, Scogin F. Clinical research with older adults. In: McKay D, editor. Handbook of research methods in abnormal and clinical psychology. Thousand Oaks, CA: SAGE Publications, Inc; 2008. p. 427–46.
    1. Hurt RD, Sachs DP, Glover ED, Offord KP, Johnston JA, Dale LC, et al. A comparison of sustained-release bupropion and placebo for smoking cessation. N Engl J Med. 1997;337(17):1195–202.
    1. Jorenby DE, Hays JT, Rigotti NA, Azoulay S, Watsky EJ, Williams KE, et al. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA. 2006;296(1):56–63.
    1. Swensen SJ, Jett JR, Hartman TE, Midthun DE, Mandrekar SJ, Hillman SL, et al. CT screening for lung cancer: five-year prospective experience. Radiology. 2005;235(1):259–65.
    1. Biener L, Abrams DB. The Contemplation Ladder: validation of a measure of readiness to consider smoking cessation. Health Psychol. 1991;10(5):360–5.
    1. Herzog TA, Abrams DB, Emmons KM, Linnan LA. Predicting increases in readiness to quit smoking: A prospective analysis using the contemplation ladder. Psychol Health. 2000;15:369–81.
    1. Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict. 1991;86(9):1119–27.
    1. SRNT Subcommittee on Biochemical Verification Biochemical verification of tobacco use and cessation. Nicotine Tob Res. 2002;4(2):149–59.
    1. Hughes JR, Keely JP, Niaura RS, Ossip-Klein DJ, Richmond RL, Swan GE. Measures of abstinence in clinical trials: issues and recommendations. Nicotine Tob Res. 2003;5(1):13–25.
    1. Nguyen TD, Attkisson CC, Stegner BL. Assessment of patient satisfaction: development and refinement of a service evaluation questionnaire. Eval Program Plann. 1983;6(3–4):299–313.
    1. . System Usability Scale (SUS). . Accessed 20 Oct 2017.
    1. Olufade AO, Shaw JW, Foster SA, Leischow SJ, Hays RD, Coons SJ. Development of the Smoking Cessation Quality of Life questionnaire. Clin Ther. 1999;21(12):2113–30.
    1. Ware JE, Jr, Sherbourne CD, The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.
    1. Tammemagi MC, Berg CD, Riley TL, Cunningham CR, Taylor KL. Impact of lung cancer screening results on smoking cessation. J Natl Cancer Inst. 2014;106(6):dju084.
    1. Ashraf H, Tonnesen P, Holst Pedersen J, Dirksen A, Thorsen H, Dossing M. Effect of CT screening on smoking habits at 1-year follow-up in the Danish Lung Cancer Screening Trial (DLCST) Thorax. 2009;64(5):388–92.
    1. van der Aalst CM, van Klaveren RJ, van den Bergh KA, Willemsen MC, de Koning HJ. The impact of a lung cancer computed tomography screening result on smoking abstinence. Eur Respir J. 2011;37(6):1466–73.
    1. Park ER, Gareen IF, Jain A, Ostroff JS, Duan F, Sicks JD, et al. Examining whether lung screening changes risk perceptions: National Lung Screening Trial participants at 1-year follow-up. Cancer. 2013;119(7):1306–13.
    1. Cox LS, Clark MM, Jett JR, Patten CA, Schroeder DR, Nirelli LM, et al. Change in smoking status after spiral chest computed tomography scan screening. Cancer. 2003;98(11):2495–501.
    1. Webb TL, Joseph J, Yardley L, Michie S. Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. 2010;12(1):e4.
    1. Borland R, Balmford J, Benda P. Population-level effects of automated smoking cessation help programs: a randomized controlled trial. Addiction. 2013;108(3):618–28.
    1. Holm S. A simple sequentially rejective multiple test procedure. Scand J Statist. 1979;6(2):65–70.
    1. Carpenter J, Kenward M. Multiple imputation and its application. West Sussex, UK: John Wiley & Sons; 2013.
    1. van Buuren S. Flexible imputation of missing data. Boca Raton, FL: Taylor & Francis Group; 2012.
    1. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Social Psych. 1986;51(6):1173–82.
    1. MacKinnon DP, Dwyer JH. Estimating mediated effects in prevention studies. Eval Rev. 1993;17(2):144–58.
    1. Sonnenberg FA, Beck JR. Markov models in medical decision making: a practical guide. Med Decis Making. 1993;13(4):322–38.
    1. Ramsey SD, Willke RJ, Glick H, Reed SD, Augustovski F, Jonsson B, et al. Cost-effectiveness analysis alongside clinical trials II-An ISPOR Good Research Practices Task Force report. Value Health. 2015;18(2):161–72.
    1. McMahon PM, Kong CY, Bouzan C, Weinstein MC, Cipriano LE, Tramontano AC, et al. Cost-effectiveness of computed tomography screening for lung cancer in the United States. J Thorac Oncol. 2011;6(11):1841–8.
    1. McMahon PM, Kong CY, Johnson BE, Weinstein MC, Weeks JC, Kuntz KM, et al. Estimating long-term effectiveness of lung cancer screening in the Mayo CT screening study. Radiology. 2008;248(1):278–87.
    1. McMahon PM, Kong CY, Weinstein MC, Tramontano AC, Cipriano LE, Johnson BE, et al. Adopting helical CT screening for lung cancer: potential health consequences during a 15-year period. Cancer. 2008;113(12):3440–9.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel