Related Experiment Videos
Patient preferences in coronary revascularization
J Hornberger1, D A Bloch, M A Hlatky
1Departments of Health Research & Policy and of Medicine, Stanford University School of Medicine, CA, USA. john.hornberger@roche.com
Insights
Patients prioritize the risk of repeat revascularization when choosing coronary revascularization procedures like angioplasty and bypass surgery. Patient preferences should guide treatment decisions.
Area of Science:
- Cardiology
- Health Services Research
Background:
- Assessing patient preferences for coronary revascularization outcomes.
- Comparing angioplasty, conventional coronary bypass surgery, and minimally invasive coronary bypass surgery.
Purpose of the Study:
- To evaluate patient preferences for consequences associated with three coronary revascularization procedures.
- To inform clinical and policy decisions regarding treatment selection.
Main Methods:
- Nationwide sample recruitment of three respondent groups: no heart disease (n=89), heart disease without prior surgery (n=97), and heart disease with prior surgery (n=118).
Main Results:
- Risk of repeat revascularization was the primary concern for 62% of respondents.
- Postprocedure pain was the second most important factor (22%).
- Angioplasty was preferred over surgical options if its 3-year repeat revascularization risk decreased to below 28% (conventional bypass) and 21% (minimally invasive bypass).
Conclusions:
- Patient preferences are crucial for individual and policy recommendations in coronary revascularization.
- Incorporating patient values can optimize the selection of revascularization strategies.
Background:
This study was performed to assess patient preferences for consequences of 3 coronary revascularization procedures: angioplasty, conventional coronary bypass surgery, and minimally invasive coronary bypass surgery.
Method:
A nationwide sample of 3 types of respondents was recruited: respondents with no heart disease (n = 89), respondents with heart disease who had not undergone cardiac surgery (n = 97), and respondents with heart disease who had undergone cardiac surgery (n = 118).
Results:
Sixty-two percent ranked the risk of repeat revascularization as the most important concern, followed by postprocedure pain (22%), time to recovery of physical functioning (8%), time in hospital (4%), and body appearance (4%). Respondents preferred angioplasty to conventional and minimally invasive cardiac surgery if the 3-year risk of repeat revascularization with angioplasty were to decline to less than 28% and 21%, respectively.
Conclusion:
These data suggest that patient preference should influence individual and policy recommendations when choosing among coronary revascularization procedures.