Grant: Operating Grant

A patient with coronary artery disease (CAD) that requires intervention is often faced with several treatment options: drug therapy (cholesterol/blood pressure lowering medications), angioplasty (widening a narrowed artery), or bypass surgery. While there are advantages and disadvantages to these choices, the best available evidence shows that all three options have comparable survival rates among patients with stable CAD (defined as an established pattern of chest pain, a history of heart attack, or documented plaque in the arteries). However, research shows that the majority of patients believe that undergoing angioplasty or bypass surgery is better than drug therapy with respect to improving survival. In some instances, other factors like physical functioning and quality of life may be more important to patients and, if discussed, may lead to a different treatment decision. In order to make the best decision for each patient, it is important to understand his/her unique values, preferences, and concerns. It is also important to ensure patients understand their individualized risk/benefit for each treatment option. Therefore, our goal is to develop an evidence-based, individualized risk/benefit assessment tool that will facilitate shared decision-making between patients and physicians during treatment selection for CAD. To develop this tool, we will meet with patients and physicians to determine what factors are most important in making a treatment decision (i.e. complications, quality of life, overall survival). This will allow us to develop a tool that is meaningful to both patients and physicians. We will test the newly developed tool in a small group of patients and physicians to ensure it meets their needs. Finally, we will consult with health authorities to determine the best way to integrate the tool into everyday clinical care, providing patients and physicians with an individualized, easy to access resource for making informed treatment decisions.