Decision Aid in Chronic Total Occlusion (CTO) Patients
Decision Aid in Chronic Total Occlusion (CTO) Patients
The aim of this study is to assess the feasibility and validity of patient-level
 randomization (vs. cluster randomization) in pilot trials of decision aid efficacy.
This is a parallel, 2-arm, randomized trial to compare an intervention group receiving CTO
 Choice (decision aid) to a control group receiving usual primary care. 100 patients and 60
 cardiologists will be randomize by computer. The investigators will measure the effect of CTO
 Choice on five outcomes: (a) patient knowledge regarding CTO of PCI or medication (risk and
 benefit); (b) quality of the decision making process for both the patient and clinician; (c)
 patient and clinician acceptability and satisfaction with the decision aid; (d) rate of
 percutaneous coronary intervention (PCI) or medication; and (e) trial processes (e.g.,
 ability to recruit participants, collect patient outcomes). To capture these outcomes, the
 investigators will use patient and clinician surveys following each visit and video
 recordings of the clinical encounters. These video recordings will also allow us to determine
 the extent to which clinicians exposed to the decision aid were able to recreate elements of
 the decision aid which control patients.
Patient:

 Inclusion Criteria:

 1. At least one lesion occluding the coronary artery detected by angiography or MSCTA.

 2. left ventricular ejection fraction ≥ 40% on transthoracic echocardiography
 measurement.

 3. No major barriers to provide written consent.

 Exclusion Criteria:

 1. Severe coexisting conditions, such as severe renal insufficiency (GFR < 30
 ml/min•1.73m2), severe hepatic dysfunction [elevated glutamic-pyruvic transaminase or
 glutamic-oxal acetic transaminase level by more than three-fold of the normal
 limitation], acute or chronic heart failure (NYHA III-IV), acute infectious diseases,
 immune disorders, malignancy, etc.

 2. Patients with cognitive impairment, severe hearing loss, or visual impairment who
 could not complete the survey.

 Cardiologist:

 Inclusion Criteria:

 1. Doctors who work in the department of Cardiology for more than 1 years.

 2. No major barriers to provide written consent.

 Exclusion Criteria:

 None.