Shared decision making in patients with stable coronary artery disease: PCI choice.
Shared decision making in patients with stable coronary artery disease: PCI choice.
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DOI：
10.1371/journal.pone.0049827
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Ting HH
中科院分区：
文献类型：
--
作者：
Coylewright M;Shepel K;Leblanc A;Pencille L;Hess E;Shah N;Montori VM;Ting HH
经皮冠状动脉介入治疗（PCI）和最佳药物治疗（OMT）是许多稳定型心绞痛患者的可比替代疗法;然而，患者可能对PCI对稳定型冠状动脉疾病（CAD）死亡和心肌梗死（MI）风险的影响存在误解。我们设计并开发了一个以患者为中心的决策辅助工具（PCI Choice），以促进稳定型CAD患者的共同决策。PCI+OMT与OMT相比的估计受益和风险显示在决策辅助工具中，使用带有自然频率和文本的象形图。我们让患者、临床医生、卫生服务研究人员和设计人员参与了20多个连续迭代的决策辅助工具，这些工具在涉及临床医生和患者的真实临床体验中进行了现场测试。决策辅助旨在促进知识转移、基于患者价值观和偏好的审议以及共享决策。我们描述了设计和开发决策辅助工具（PCI选择）的方法和结果，以促进临床医生和患者之间关于PCI+OMT与OMT治疗稳定型CAD的选择的共同决策。我们将在即将进行的随机试验中评估PCI选择对患者知识、决策冲突、决策参与和治疗选择的影响。
Percutaneous coronary intervention (PCI) and optimal medical therapy (OMT) are comparable, alternative therapies for many patients with stable angina; however, patients may have misconceptions regarding the impact of PCI on risk of death and myocardial infarction (MI) in stable coronary artery disease (CAD). We designed and developed a patient-centered decision aid (PCI Choice) to promote shared decision making for patients with stable CAD. The estimated benefits and risks of PCI+OMT as compared to OMT were displayed in a decision aid using pictographs with natural frequencies and text. We engaged patients, clinicians, health service researchers, and designers with over 20 successive iterations of the decision aid, which were field tested during real-world clinical encounters involving clinicians and patients. The decision aid is intended to facilitate knowledge transfer, deliberation based on patient values and preferences, and shared decision making. We describe the methods and outcomes of the design and development of a decision aid (PCI Choice) to promote shared decision making between clinicians and patients regarding the choice of PCI+OMT vs. OMT for treatment of stable CAD. We will evaluate the impact of PCI Choice on patient knowledge, decisional conflict, participation in decision-making, and treatment choice in an upcoming randomized trial.
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影响因子：
120.7
作者：
Chan, Paul S.;Patel, Manesh R.;Klein, Lloyd W.;Krone, Ronald J.;Dehmer, Gregory J.;Kennedy, Kevin;Nallamothu, Brahmajee K.;Weaver, W. Douglas;Masoudi, Frederick A.;Rumsfeld, John S.;Brindis, Ralph G.;Spertus, John A.
通讯作者：
Spertus, John A.
影响因子：
11.3
作者：
Hannan, Edward L.;Samadashvili, Zaza;King, Spencer B., III
通讯作者：
King, Spencer B., III
影响因子：
5.9
作者：
Montori, Victor M.;Shah, Nilay D.;Wermers, Robert A.
通讯作者：
Wermers, Robert A.
影响因子：
--
作者：
Mullan, Rebecca J.;Montori, Victor M.;Smith, Steven A.
通讯作者：
Smith, Steven A.
影响因子：
2.3
作者：
Patel, Manesh R.;Dehmer, Gregory J.;Spertus, John A.
通讯作者：
Spertus, John A.