title: Shared decision making in patients with stable coronary artery disease: PCI choice.
abstract: BACKGROUND
  Percutaneous coronary intervention (PCI) and optimal medical therapy (OMT) are comparable, alternative therapies for many patients with stable angina; however, patients may have misconceptions regarding the impact of PCI on risk of death and myocardial infarction (MI) in stable coronary artery disease (CAD).
  
  
  RESULTS
  We designed and developed a patient-centered decision aid (PCI Choice) to promote shared decision making for patients with stable CAD. The estimated benefits and risks of PCI+OMT as compared to OMT were displayed in a decision aid using pictographs with natural frequencies and text. We engaged patients, clinicians, health service researchers, and designers with over 20 successive iterations of the decision aid, which were field tested during real-world clinical encounters involving clinicians and patients. The decision aid is intended to facilitate knowledge transfer, deliberation based on patient values and preferences, and shared decision making.
  
  
  CONCLUSIONS
  We describe the methods and outcomes of the design and development of a decision aid (PCI Choice) to promote shared decision making between clinicians and patients regarding the choice of PCI+OMT vs. OMT for treatment of stable CAD. We will evaluate the impact of PCI Choice on patient knowledge, decisional conflict, participation in decision-making, and treatment choice in an upcoming randomized trial.
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Coylewright
authors.forename: Kathy
authors.initials: K
authors.lastname: Shepel
authors.forename: Annie
authors.initials: A
authors.lastname: Leblanc
authors.forename: Laurie
authors.initials: L
authors.lastname: Pencille
authors.forename: Erik
authors.initials: E
authors.lastname: Hess
authors.forename: Nilay
authors.initials: N
authors.lastname: Shah
authors.forename: Victor M
authors.initials: VM
authors.lastname: Montori
authors.forename: Henry H
authors.initials: HH
authors.lastname: Ting
mesh_terms: D060050:Angina, Stable / Q000523:psychology / Q000628:therapy*; D002316:Cardiotonic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002755:Choice Behavior; D003324:Coronary Artery Disease / Q000523:psychology / Q000628:therapy*; D003657:Decision Making; D003661:Decision Support Techniques; D003663:Decision Trees; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009203:Myocardial Infarction / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000193:education / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic
chemical_list: D002316:Cardiotonic Agents