Patients’ preferences for coronary revascularization: a systematic review

Figures & data

Figure 1 PRISMA flow chart of search strategy.

Abbreviation: CAD, coronary artery disease.

Table 1 Summary of evidence

Study and country	Population	Objectives	Methods	Main results
Pandit et al 2014^Citation6 USA	54 patients, 57 physicians	To assess the relative weight each group (patients and physicians) places on potential adverse outcomes from either PCI or CABG	Rating outcomes on a scale of 0–10	Patients weighted stroke the heaviest and repeat PCI 15 out of 20 outcomes. Physicians weighted death as the heaviest
Chow et al 2014^Citation7 USA	100 patients	To determine the preferences of patients regarding outcomes included on the design of cardiovascular trials	Rating (heart attack, heart death, death, chest pain-hospitalization, repeat revascularization and stroke) on a scale from 1 to 6	Heart attack and death from heart disease were the most important endpoints to be included in a cardiovascular trial.
Ahmad et al 2015^Citation8 UK	113 patients, 50 cardiologists	To determine the preferences of patients regarding outcomes included on the design of cardiovascular trials	Visual analog scale. The relative importance of myocardial infarction, stroke, and repeat revascularization indexed to the death’s value	Patients considered stroke worse than death. Patients valued outcomes significantly different than physicians.
Hornberger et al 1999^Citation2 USA	304 respondents	Determinants of clinical decision-making in patients with stable coronary artery disease	Conjoint analysis, ranking/rating, standard gamble, and WTP. Outcomes: scar, pain, recovery time, days in hospital and repeat revascularization	Repeat revascularization was the most important outcome (28% risk rate threshold to change PCI/CABG.).
Kipp et al 2013^Citation9 USA	585 patients, 31 physicians	Determinants of clinical decision-making in patients with stable coronary artery disease	Mixed effects logistic regression analysis. Outcomes: death, stroke and repeat revascularization	Patients preferred PCI over CABG more than physicians and even when the risk of death was double, and the risk of repeat procedures was more than three times the CABG risks.
Bowling et al 2008^Citation10 UK	53 patients	Preferences for angina treatments among patients admitted from emergency with acute coronary syndrome	Rank/rating. Four treatment options: CABG, PCI, drugs to prevent symptoms or to prevent symptoms and partly to reduce the risks of a heart attack	PCI was the preferred treatment (80%), followed by CABG (19%).

Abbreviations: CABG, coronary artery bypass grafting; PCI, percutaneous coronary intervention; WTP, willingness to pay.

Table S1 Full eletronic search strategy executed on Medline, Embase and Lilacs databases for studies regarding patients’ preferences for coronary revascularization

Database	Strategy
Medline	(“coronary artery bypass”[Title/Abstract] OR “myocardial revascularization”[Title/Abstract] OR “coronary angioplasty”[Title/Abstract] OR “coronary artery disease”[Title/Abstract] OR “coronary stent*”[Title/Abstract] OR CABG [Title/Abstract]) AND (“patient reported outcome” [Title/Abstract] OR “patient-reported outcome” [Title/Abstract] OR “Patient Satisfaction”[Title/Abstract] OR “Best-Worst Scaling”[Title/Abstract] OR MaxDiff[Title/Abstract] OR “discrete choice”[Title/Abstract] OR preference[Title/Abstract] OR preferences’[Title/Abstract] OR “part-worth utilities”[Title/Abstract] OR “functional measurement”[Title/Abstract] OR “paired comparisons”[Title/Abstract] OR “pairwise choices”[Title/Abstract] OR “conjoint measurement”[Title/Abstract] OR “conjoint studies”[Title/Abstract] OR “conjoint choice experiment”[Title/Abstract] OR vignette[Title/Abstract] OR vignette’s[Title/Abstract] OR vignetted[Title/Abstract] OR vignettes[Title/Abstract] OR “choice behaviour”[Title/Abstract] OR “choice behaviors”[Title/Abstract] OR willingness-to-pay[Title/Abstract] OR “conjoint analyses”[Title/Abstract] OR conjoint analysis[Title/Abstract])
EMBASE	‘coronary artery bypass’:ab,ti OR ‘myocardial revascularization’:ab,ti OR angioplasty:ab,ti OR ‘coronary artery disease’:ab,ti OR ‘coronary stent*’:ab,ti AND (‘patient satisfaction’/exp OR ‘best-worst scaling’:ab,ti OR maxdiff:ab,ti OR ‘maximum difference scaling’:ab,ti OR ‘best worst scaling’:ab,ti OR ‘discrete choice’:ab,ti OR preference:ab,ti OR ‘part-worth utilities’:ab,ti OR ‘functional measurement’:ab,ti OR ‘paired comparisons’:ab,ti OR ‘pairwise choices’:ab,ti OR ‘conjoint measurement’:ab,ti OR ‘conjoint studies’:ab,ti OR ‘conjoint choice experiment’:ab,ti OR vignette:ab,ti OR ‘choice behavior’/exp OR ‘willingness to pay’:ab,ti OR ‘conjoint analyses’:ab,ti) AND [embase]/lim NOT [medline]/lim AND (‘article’/it OR ‘article in press’/it OR ‘review’/it)
Lilacs	(‘best-worst scaling’ OR maxdiff OR discrete choice OR ‘escolha discreta’ OR preference OR preferencia OR ‘part-worth utilities’ OR vignette OR ‘choice behavior’ OR ‘willingness to pay’) AND (angina OR angioplasty OR angioplastia OR myocardial revascularization OR miocárdica OR coronary OR coronaria)

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HornbergerJBlochDAHlatkyMABaumgartnerWPatient preferences in coronary revascularizationAm Heart J199913761153116210347345

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KippRLehmanJIsraelJEdwardsNBeckerTRavalANPatient preferences for coronary artery bypass graft surgery or percutaneous intervention in multivessel coronary artery diseaseCatheter Cardiovasc Interv201382221221822517566

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BowlingACullifordLSmithDRoweGReevesBCWhat do patients really want? Patients’ preferences for treatment for anginaHealth Expect200811213714718494958

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