Few patients appear to have been engaged in medical device decision-making. For example, among Medicare beneficiaries who underwent elective coronary artery stenting in 2008, few reported having discussed treatment options (10%), associated risks (19%) or their treatment preferences (16%) . Among 17 of 22 standardized patients, visits with American cardiologists did not address, or minimized quality-of-life issues and the risks of implantable cardioverter-defibrillator (ICD) placement . All respondents to a survey of American patients who had joint replacement said that benefits were discussed more than risks . In another study of patients undergoing knee arthroplasty in one Canadian centre, most had little knowledge of the risks and benefits of options for devices and surgical approaches, and desired more information .