CardSort data for treatment features and goals for aortic stenosis

Background: Guidelines recommend including the patient’s values and
preferences when choosing treatment for severe aortic stenosis (sAS).
However, little is known about what matters most to patients as they
develop treatment preferences. Our objective was to identify, prioritize,
and organize patient-reported goals and features of treatment for sAS.
Results: 51 adults with sAS and 3 caregivers with experience choosing
treatment (age 36-92 years) were included. Participants were referred from
multiple health centers across the U.S. and online. Eight nominal group
meetings generated 32 unique treatment goals and 46 treatment features,
which were grouped into 10 clusters of goals and 11 clusters of features.
The most important clusters were: 1) trust in the healthcare team, 2)
having good information about options, and 3) long-term outlook. Other
clusters addressed the need for and urgency of treatment, being
independent and active, overall health, quality of life, family and
friends, recovery, homecare, and the process of decision-making.
Conclusions: These patient-reported items addressed the impact of the
treatment decision on the lives of patients and their families from the
time of decision-making through recovery, homecare, and beyond. Many
attributes had not been previously reported for sAS. The goals and
features that patients’ value, and the relative importance that they
attach to them, differ from those reported in clinical trials and vary
substantially from one individual to another. These findings are being
used to design a shared decision-making tool to help patients and their
clinicians choose a treatment that aligns with the patients’ priorities.