A Careful Consideration of the Effect of a Decision Aid on Agreement Between Patient Preferences and Repair Type for Abdominal Aortic Aneurysm—Reply

Open or Endovascular Repair for Abdominal Aortic Aneurysm—Would a Decision Aid Help?

“…In this issue of JAMA Surgery , Eid et al presented a randomized clinical study aimed to determine if a preconsultation-administered decision aid would affect a patient’s choice between open or endovascular repair (EVAR) for abdominal aortic aneurysm. Their results showed that patients exposed to a decision aid were more likely to receive the repair they preferred.…”

“…The choice of open repair vs EVAR is complex, and as detailed in the study by Eid et al, it involved detailed discussions between patients and the vascular surgeon who actually performed the repair. The decision aid provided good information on morbidity, hospital stay, and reintervention risk but without technical and anatomic details.…”

“…In the study by Eid et al, the visit to the vascular surgeon seemed to be the final determining factor, and irrespective of decision aid, a very similar proportion of patients chose EVAR over open repair in both groups. Up to 2 years had lapsed between the decision and the actual surgery, and much could have changed during this period to affect the patient’s decision.…”

“…After reviewing the study by Eid et al, one must conclude that the decision aid provided basic information to the patients before a consultation with an expert up to 2 years before the actual surgery. The final decision would rest more on surgeon preference, aneurysm anatomy, and patient comorbidity.…”