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Cognitive interviews refined a decision aid for stable coronary artery disease (CAD) patients considering stress testing. Patient feedback improved clarity and usability for shared decision-making (SDM).

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Area of Science:

  • Cardiology
  • Medical Informatics
  • Patient Education

Background:

  • Stable coronary artery disease (CAD) management involves shared decision-making (SDM).
  • Decision aids (DAs) support SDM by providing patient-centered information.
  • Refining DAs is crucial for effective patient engagement.

Purpose of the Study:

  • To refine the "Making Choices©" Decision Aid (DA) for SDM regarding stress testing in stable CAD patients.
  • To assess the clarity, usefulness, and design of the DA through cognitive interviews.
  • To ensure the DA aligns with International Patient Decision Aid Standards (IPDAS).

Main Methods:

  • Systematic development process adhering to IPDAS and Alpha testing criteria.
  • Cognitive interviews utilizing the "think aloud" technique with ten stable CAD patients.
  • Assessment of each DA page for patient comprehension and usability.

Main Results:

  • Patients identified three key messages regarding stress testing options and physician discussion.
  • Feedback led to revisions, correcting an inaccurate assumption about stress tests being the sole "gold standard."
  • The DA's clarity, usefulness, and design were enhanced based on patient input.

Conclusions:

  • Cognitive interviews are essential for patient engagement in DA development.
  • Clear message development and user-friendly design principles are critical for effective DAs.
  • Patient perspectives gained through cognitive interviews significantly improve systematic DA development.