Variationss in cardiologists' treatment advice for elderly patientss with aortic stenosis: a nation-wide survey in the Netherlands s
نویسندگان
چکیده
t Thee objective was to determine the influence of the patients' age, cardiac signs andd symptoms, and co-morbidity on the cardiologists' decisions to advise surgery, ass well as to identify groups of cardiologists who are influenced by these characteristicss in a similar way. Wee performed a Nation-wide postal survey among all 530 cardiologists in the Netherlands.. With a questionnaire cardiologists were asked to indicate on a 6pointt scale whether they would advise cardiac surgery for each of 32 case vignettes.. The vignettes were designed is such a way that the influence of each off 10 clinical characteristics on the cardiologist's decision to advise surgery could bee estimated independently of the 9 others. Fifty-toww percent of the cardiologists responded. There was marked variationn in the cardiologists' treatment advice. We could explain 60% of the variancee in the cardiologists' advice scores by distinguishing 6 groups. 41% of thee cardiologists were predominantly influenced by the age of the patients, and 50%% of them had a high and 50% a low inclination towards surgery. 24% were influencedd equally by the patients' age as by the severity of the aortic stenosis andd the left ventricular function, and 62% of them had a high and 38% a low inclinationn towards surgery. In addition to the influence of age, 23% of the cardiologistss were mainly influenced by the left ventricular function, and 12% by thee aortic valve area. The presence of co-morbidity always played a minor role. Cardiologistss varied systematically according to the extent they were inclinedd to advise surgery as well as the way they were influenced by clinical characteristics.. These results indicate the need for prospective studies to identify thee best treatment for elderly patients according to their clinical profile. 72 2 variationn in cardiologists' treatment
منابع مشابه
Variability in treatment advice for elderly patients with aortic stenosis: a nationwide survey in The Netherlands.
OBJECTIVE To determine how the decisions of Dutch cardiologists on surgical treatment for aortic stenosis were influenced by the patient's age, cardiac signs and symptoms, and comorbidity; and to identify groups of cardiologists whose responses to these clinical characteristics were similar. DESIGN A questionnaire was produced asking cardiologists to indicate on a six point scale whether they...
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