Prioritising the cardiac surgery waiting list: the angina patient's perspective.

OBJECTIVE To determine patients' views on how clinical and demographic factors should affect priorities for cardiac revascularisation. DESIGN A descriptive survey of patients' views conducted immediately after angiography and treatment counselling. SUBJECTS 136 patients who were awaiting coronary angioplasty in either of the two regional cardiology centres in Northern Ireland. RESULTS About half the subjects (52%) felt that certain social factors such as having dependent relatives should be taken into account when deciding priority for surgery. A sizeable minority felt that younger subjects and non-smokers (40% and 44%, respectively) should be accorded higher priority, with older subjects and smokers being more likely to hold such views. CONCLUSIONS While there is little evidence that demographic and lifestyle factors affect the relative efficacy of surgery, the challenge remains to devise a prioritisation guideline that can properly reflect societal values and the evidence base.