Improving shared decision-making and risk communication in vascular surgery

Le résumé fourni par la source

Shared decision-making (SDM) is the concept of involving both healthcare professionals and patients in incorporating the patient’s preferences into the final treatment decision in order to improve quality of care. Vascular surgical patients may especially benefit from SDM as there is usually more than one treatment option available and treatment decisions can be highly preference-sensitive. Therefore, it is important for vascular surgeons to understand the concerns and treatment goals of their patients. As this may very well affect whether non-surgical treatment is continued, endovascular treatment or a more invasive open surgical treatment is performed. For example, patients with an abdominal aortic aneurysm face multiple concerns when deciding between endovascular aortic aneurysm repair (EVAR) and open surgical repair. One of these concerns entails the need for follow-up after EVAR. Patients who undergo EVAR are required to undergo lifelong yearly imaging surveillance, since 22% of patients develop complications that will require one or more reinterventions. Unfortunately, yearly imaging surveillance with computed tomography may also harm patients by risking contrast-nephropathy and an increased attributable lifetime cancer risk. The first part of this thesis focusses on ways to measure and improve SDM in vascular surgery. For example by the development of different decision support tools. The second part of this thesis focusses on ways to improve risk communication with vascular surgical patients, which is a key aspect of SDM. The third part of this thesis focusses on the benefits and harms of yearly imaging surveillance following EVAR.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.