Arrhythmias & electrophysiology
Facilitating Shared Decision Making Among Black Patients at Risk for Sudden Cardiac Arrest : A Randomized Clinical Trial
Primary result · Assent to ICD implantationResult — go to the resultDifference −0.8 percentage point 95% CI −13.2 to 11.1Authors' conclusion
A video-based decision support tool increased patient knowledge but did not increase assent to ICD implantation.
Study context
- Population
- Black adults with HF eligible for a primary prevention implantable cardioverter-defibrillator (ICD)311 contributed primary-outcome data
- Participants
- 330 adults
- Comparison
- Video decision support tool vs usual care
- Primary endpoint
- Decision regarding ICD implantation (assent)
Methodological detailsmulticentre, 14 US academic and community-based electrophysiology clinics, CMS implemented a shared decision-making requirement for ICD implantation during the study
- Multicentre
- 14 US academic and community-based electrophysiology clinics
- CMS implemented a shared decision-making requirement for ICD implantation during the study
Primary result
Assent to ICD implantation
Difference
−0.8 percentage point
95% CI −13.2 to 11.1
By group
Video vs Usual care
difference −0.8 percentage point (95% CI −13.2 to 11.1)
As reported in the abstract
Further findings
| Outcome | Difference (CI) | |
|---|---|---|
| Mean knowledge score | 0.7 (0.2–1.1) | |
| Decisional conflict score | −2.6 (−5.7 to 0.4) | |
| −10−505Difference (linear scale) |
Mean, minutes
| Outcome | Video | Usual care | Difference (minutes) (CI) | |
|---|---|---|---|---|
| Time spent with clinician | 22.1 | 27.0 | −4.9 (−9.4 to −0.3) | |
| −10−505Difference, minutes (linear scale) |
ICD implantation within 90 days
- ICD implantation rate (overall), no differences by intervention
- 65.7%
Effect of racial concordance between video and participants
- Racial concordance did not affect study outcomes
Original publication
Facilitating Shared Decision Making Among Black Patients at Risk for Sudden Cardiac Arrest : A Randomized Clinical Trial. Ann Intern Med. Published 4 April 2023. doi:10.
Summarised from the published abstract; every number is checked against it