Loren Berman|Leslie Curry|Carolyn G. Goldberg|Richard J. Gusberg|Liana Fraenkel
Pilot testing of a decision support tool for patients with abdominal aortic aneurysms
Robert Wood Johnson Foundation|Yale University|Yale University|Robert Wood Johnson Foundation|VA Connecticut Healthcare System|Connecticut Health Foundation|Yale University|VA Connecticut Healthcare System|Connecticut Health Foundation|Yale University|VA Connecticut Healthcare System|Connecticut Health Foundation|Yale University
objectivepatients abdominal aortic aneurysms aaas surgical candidates many three options open surgery endovascular surgery surgery treatment decisions informed patient preferences critical decision support tools potential better inform patients risks benefits associated treatment option empower patients participate meaningfully decisionmaking process objective study develop pilot test decision support tool patients aaasmethodswe developed personalized interactive computerbased decision support tool reflecting current outcomes data input surgeons patients piloted tool aaa repair candidates used tool prior meeting surgeon patients recruited universitybased vascular surgery clinic affiliated va hospital clinic determine feasibility acceptability following outcomes measured 1 percent patients agreed participate 2 length time required use tool 3 amount assistance required use tool 4 patients opinions acceptability tool assess effectiveness tool measured change knowledge decisional conflict pre posttool using paired ttestresultsone hundred percent patients approached n 12 agreed participate study tool administered median time 35 minutes range 2545 minutes patients able navigate program minor technical assistance mean knowledge scores increased 56 90 p 005 decisional conflict scores decreased 29 8 p 04 overall patients reported program content balanced across treatment options presented information clearly concisely helped organize thoughts decision prepared talk surgeon mattered themconclusionspreliminary evidence suggests use evidencebased aaa decision support tool feasible acceptable patients increases knowledge decreases decisional conflict widespread use tool might improve content quality informed consent difficult treatment decision patients abdominal aortic aneurysms aaas surgical candidates many three options open surgery endovascular surgery surgery treatment decisions informed patient preferences critical decision support tools potential better inform patients risks benefits associated treatment option empower patients participate meaningfully decisionmaking process objective study develop pilot test decision support tool patients aaas developed personalized interactive computerbased decision support tool reflecting current outcomes data input surgeons patients piloted tool aaa repair candidates used tool prior meeting surgeon patients recruited universitybased vascular surgery clinic affiliated va hospital clinic determine feasibility acceptability following outcomes measured 1 percent patients agreed participate 2 length time required use tool 3 amount assistance required use tool 4 patients opinions acceptability tool assess effectiveness tool measured change knowledge decisional conflict pre posttool using paired ttest one hundred percent patients approached n 12 agreed participate study tool administered median time 35 minutes range 2545 minutes patients able navigate program minor technical assistance mean knowledge scores increased 56 90 p 005 decisional conflict scores decreased 29 8 p 04 overall patients reported program content balanced across treatment options presented information clearly concisely helped organize thoughts decision prepared talk surgeon mattered preliminary evidence suggests use evidencebased aaa decision support tool feasible acceptable patients increases knowledge decreases decisional conflict widespread use tool might improve content quality informed consent difficult treatment decision