Treatment Decisions for Multi-vessel CAD
Treatment Decisions for Multi-vessel CAD
This study is a multi-center randomized trial to evaluate the Multi-vessel Coronary Artery
 Disease Option Grid patient decision aid compared to usual care in patient reported
 decisional conflict, knowledge, and shared decision making.
Multi-vessel coronary artery disease can be treated through percutaneous coronary
 intervention, coronary artery bypass grafting, or medical therapy. Treatments have risk
 benefit tradeoffs, making patient preference integral to the treatment decision. The
 Multi-vessel Coronary Artery Disease Option Grid patient decision aid was developed to
 improve the decision making process for patients and clinicians.

 Objectives:

 1. Evaluate The Multi-vessel Coronary Artery Disease Option Grid impact on patient
 treatment decisional conflict, knowledge, and shared decision making.

 The randomized controlled trial will compare validated and standardized measures of
 patient decisional conflict, shared decision making, and condition specific treatment
 knowledge between Option Grid and usual care patients. The investigators hypothesize
 Option Grid patients will have improvements in patient decisional conflict, shared
 decision making, and knowledge compared to usual care patients. Baseline feasibility
 enrollment at each site prior to randomization will be used to identify current
 treatment patterns, and prepare intervention delivery and fidelity. Registry data will
 be used to identify patient treatment received and compared between Option Grid and
 usual care arms.

 2. Examine the physician and patient process of and factors influencing Multi-vessel
 Coronary Artery Disease Option Grid use.

 Semi-structured interviews and process evaluations will be used to describe Option Grid use
 and experience and identify factors that are associated with beneficial Option Grid use.
Inclusion Criteria:

 -  Stable multi-vessel coronary artery disease diagnosed by coronary angiography defined
 as left main disease (>50% stenosis) or multi-vessel coronary artery disease (>70%
 stenosis in two or more coronary arteries)

 -  At relative equipoise for at least two potential treatment options, in which the
 treating cardiologist or surgeon has determined the treatments are anatomically
 feasible and safe.

 Exclusion Criteria:

 -  Prior coronary artery bypass grafting

 -  Unable to read or write English

 -  Not cognitively able to participate in the Option Grid as determined by clinician