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Clinical Trial
. 2000 Oct;15(10):685-93.
doi: 10.1046/j.1525-1497.2000.91139.x.

Randomized, controlled trial of an interactive videodisc decision aid for patients with ischemic heart disease

M W Morgan  1 , R B Deber, H A Llewellyn-Thomas, P Gladstone, R J Cusimano, K O'Rourke, G Tomlinson, A S Detsky
Affiliations
Clinical Trial

Randomized, controlled trial of an interactive videodisc decision aid for patients with ischemic heart disease

M W Morgan et al. J Gen Intern Med. 2000 Oct.

Abstract

Objective: To determine the effect of the Ischemic Heart Disease Shared Decision-Making Program (IHD SDP) an interactive videodisc designed to assist patients in the decision-making process involving treatment choices for ischemic heart disease, on patient decision-making.

Design: Randomized, controlled trial.

Setting: The Toronto Hospital, University of Toronto, Toronto, Ontario, Canada.

Participants: Two hundred forty ambulatory patients with

Measurements and main results: The primary outcome was patient satisfaction with the decision-making process. This was measured using the 12-item Decision-Making Process Questionnaire that was developed and validated in a randomized trial of the benign prostatic hyperplasia SDP. Secondary outcomes included patient knowledge (measured using 20 questions about knowledge deemed necessary for an informed treatment decision), treatment decision, patient-angiographer agreement on decision, and general health scores. Outcomes were measured at the time of treatment decision and/or at 6 months follow-up. Shared decision-making program scores were similar for the intervention and control group (71% and 70%, respectively; 95% confidence interval [CI] for 1% difference, -3% to 7%). The intervention group had higher knowledge scores (75% vs 62%; 95% CI for 13% difference, 8% to 18%). The intervention group chose to pursue revascularization less often (58% vs 75% for the controls; 95% CI for 17% difference, 4% to 31%). At 6 months, 52% of the intervention group and 66% of the controls had undergone revascularization (95% CI for 14% difference, 0% to 28%). General health and angina scores were not different between the groups at 6 months. Exposure to the IHD SDP resulted in more patient-angiographer disagreement about treatment decisions.

Conclusions: There was no significant difference in satisfaction with decision-making process scores between the IHD SDP and usual practice groups. The IHD SDP patients were more knowledgeable, underwent less revascularization (interventional therapies), and demonstrated increased patient decision-making autonomy without apparent impact on quality of life.

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Figures

FIGURE 1
FIGURE 1
Profile of patient recruitment.
See this image and copyright information in PMC

Comment in

References

    1. Murray CJL, Lopez AD. Mortality by cause for eight regions of the world: global burden of disease study. Lancet. 1997;349:1269–76. - PubMed
    1. Peters S, Chagani K, Paddon P, Nair C. Coronary artery bypass surgery in Canada. Health Reports. 1990;2:9–26. - PubMed
    1. Ugnat AM, Naylor CD. Trends in coronary artery bypass grafting in Ontario from 1981 to 1989. CMAJ. 1993;148:569–75. - PMC - PubMed
    1. Peterson ED, Jollis JG, Bebchuk JD, et al. Changes in mortality after myocardial revascularization in the elderly: the national Medicare experience. Ann Intern Med. 1994;121:919–27. - PubMed
    1. Yusuf S, Zucker D, Peduzzi P, et al. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration [published erratum appears in Lancet 1994; 344:1446]. Lancet. 1994;344:563–70. Comments. - PubMed

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