IMPORTANCEPatients with abdominal aortic aneurysm (AAA) can choose open repair or endovascular repair (EVAR). While EVAR is less invasive, it requires lifelong surveillance and more frequent aneurysm-related reinterventions than open repair. A decision aid may help patients receive their preferred type of AAA repair.OBJECTIVE To determine the effect of a decision aid on agreement between patient preference for AAA repair type and the repair type they receive.
DESIGN, SETTING, AND PARTICIPANTSIn this cluster randomized trial, 235 patients were randomized at 22 VA vascular surgery clinics. All patients had AAAs greater than 5.0 cm in diameter and were candidates for both open repair and EVAR.
This essay challenges two established critical assumptions about late Victorian literary decadence: first, that decadence represented a sterile and ultimately failed attempt to defy social and cultural norms and, second, that the movement was antithetical to the scientific culture of the nineteenth century. Decadence is instead shown to be the logical consequence of a scientific spirit that, by the end of the century, increasingly ignored the demands of utilitarianism and fixated on the pursuit of experimental knowledge for its own sake, regardless of the consequences. Thus, the “failures” of the subject that so frequently mark the end of accounts of decadence such as Wilde's The Picture of Dorian Gray, Collins's Heart and Science, and Machen's The Great God Pan represent the triumph of a historically specific experimental ethos that valued the transcendence of conventional epistemology over the discovery of useful knowledge.
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