Impact of personalized risk scores on shared decision making in left ventricular assist device implantation: Findings from a qualitative study.
Holland Kaplan, Kristin Kostick-Quenet, Benjamin Lang and 2 others
PMID 39288559WHAT IT FOUND
Patients and caregivers considering LVAD almost universally wanted personalized risk scores discussed by their physician, not received alone.
Clinicians varied: some preferred withholding scores until a visit, others said nurse coordinators or advanced practice providers could discuss them.
Key findings
01Patients and caregivers preferred shared decision making with physicians over independent access to personalized risk scores.
02Clinicians varied in how they would share personalized risk scores: some preferred discussing them only in a clinical encounter, while others favored giving patients independent access outside the visit.
03Some physicians were willing to delegate personalized risk score discussions to nurse coordinators or advanced practice providers, but patients preferred their physician for these discussions.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The interviews captured perceptions about a personalized risk score decision aid that was still in development, not actual experience using it. Snowball sampling through clinician champions may have favored participants already engaged or familiar with LVAD decision making. Caregivers were underrepresented. Patients and caregivers were not specifically asked whether discussing personalized risk scores with advanced practice providers would be acceptable.
Declared interests
The authors declare no commercial or financial conflicts of interest.
The easy way to misread this
Do not read independent access to personalized risk scores as sufficient shared decision making. Patients in this study preferred physician discussion, and the decision aid was not tested in real encounters.