Physician preferences for revascularization in patients with ischemic cardiomyopathy: Defining equipoise from web-based surveys

Autor: Amrita Mukhopadhyay, John Spertus, Sripal Bangalore, Yan Zhang, Thaddeus Tarpey, Judith Hochman, Stuart Katz
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: American Heart Journal Plus, Vol 26, Iss , Pp 100263- (2023)
Druh dokumentu: article
ISSN: 2666-6022
DOI: 10.1016/j.ahjo.2023.100263
Popis: Background: The optimal revascularization approach in patients with heart failure with reduced ejection fraction (HFrEF) and ischemic heart disease (“ischemic cardiomyopathy”) is unknown. Physician preferences regarding clinical equipoise for mode of revascularization and their willingness to consider offering enrollment in a randomized trial to patients with ischemic cardiomyopathy have not been characterized. Methods: We conducted two anonymous online surveys: 1) a clinical case scenario-based survey to assess willingness to offer clinical trial enrollment for a patient with ischemic cardiomyopathy (overall response rate to email invitation 0.45 %), and 2) a Delphi consensus-building survey to identify specific areas of clinical equipoise (overall response rate to email invitation 37 %). Results: Among 304 physicians responding to the clinical case scenario-based survey, the majority were willing to offer the opportunity for clinical trial enrollment to a prototypical patient with ischemic cardiomyopathy (92 %), and felt that a finding of non-inferiority for PCI vs. CABG would influence their clinical practice (78 %). Among 53 physicians responding to the Delphi consensus-building survey, the median appropriateness rating for CABG was significantly higher than that of PCI (p
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