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Decision Tree. Colleen K. McIlvennan, DNP, ANP Assistant Professor of Medicine Section of Advanced Heart Failure and Transplantation INTERMACS 2016. Disclosures. None. Outline. What is Shared Decision Making? LVAD Therapy (DT) Decision Support Tools. 1. What is Shared Decision Making?.
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Decision Tree Colleen K. McIlvennan, DNP, ANP Assistant Professor of Medicine Section of Advanced Heart Failure and Transplantation INTERMACS 2016
Disclosures • None.
Outline • What is Shared Decision Making? • LVAD Therapy (DT) • Decision Support Tools
Classes of Treatment Decisions Benefit When scientific evidence for benefit strongly outweighs harm, behavioral support (e.g. smoking cessation, beta-blocker) designed to describe, justify, and recommend is most appropriate. Risk
Classes of Treatment Decisions Benefit LVAD 32F peri-partum CM INTERMACS 2 Risk
Classes of Treatment Decisions Shared decision makingis most easily applied to preference-sensitive decisions, to help patients think through, forecast, and deliberate their options. Benefit Risk
Classes of Treatment Decisions LVAD 75M multi-morbidity INTERMACS 5 Benefit Risk
McIlvennan, Magid, Ambardekar, Thompson, Matlock, Allen. Circ Heart Fail. 2015
Dichotomy in Approach McIlvennan et al. Circ Cardiovasc Qual Outcomes. 2014
Dichotomy in Approach McIlvennan et al. Circ Cardiovasc Qual Outcomes. 2014
Explain and define the medically reasonable options Shared Decision-Making Process describe the risks, benefits, burdens of each option solicitation of patient preferences, values, goals
Decision Aids www.patientdecisionaid.org
Thompson, Matlock, McIlvennan, Jenkins, Allen. JACC Heart Fail. 2015
Thompson, Matlock, McIlvennan, Jenkins, Allen. JACC Heart Fail. 2015
Future Directions • Ideal timing? • Does indication matter? • New technology
Questions? colleen.mcilvennan@ucdenver.edu