Hu Yiyuan David, Jones James M, Sensenig Catherine J, Eid Mark A, Mehta Kunal, Goldwag Jenaya L, Barnes Jonathan A, Moore Kayla O, Halpern Vivienne, Henke Peter, Tang Gale, Mureebe Leila, Alabi Olamide, Tzeng Edith, Stone David, Brooke Benjamin, Nelson Peter, Spangler Emily, Barry Michael, Kang Ravinder, Scali Salvatore, O'Connell Jessica, Goodney Philip
The Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire.
Smith College, Northampton, Massachusetts.
J Surg Res. 2022 Jul;275:149-154. doi: 10.1016/j.jss.2021.12.036. Epub 2022 Mar 10.
The PReferences for Open Versus Endovascular Repair of Abdominal Aortic Aneurysm (PROVE-AAA) trial aimed to determine the efficacy of a validated decision aid to enable better alignment between patient preference and their ultimate repair. We sought to determine the key factors influencing the decision-making of veterans for endovascular repair of abdominal aortic aneurysm (EVAR) or open surgical repair (OSR).
A total of 235 veterans in the PROVE-AAA trial were asked their information sources regarding repairs, employment status, and preferred intervention. Answers were coded and analyzed using conventional content analysis to generate nonoverlapping themes, then stratified by employment status.
Forty-two patients (17.8% of enrollees) provided their source of information for OSR prior to using a decision aid. 81% of retired veterans were greater than 70 y old, while 58% of nonretired veterans were greater than 70 (P = 0.003). The most common information source was from a vascular surgeon/professional or unspecified MD/other health professionals (51.4%), while sources from outside this group made up the remaining 48.5%. The most preferred procedure was EVAR. However, nonretired individuals were more likely to prefer OSR. These data on information source and preferred procedure were similar in patients who provided their source for EVAR.
Veterans in the PROVE-AAA study were more likely to be retired and more likely to rely on information from an unspecified MD/other health professionals for EVAR. Although both retired and nonretired veterans preferred EVAR the most, nonretired veterans were more likely to prefer OSR despite being younger.
腹主动脉瘤开放修复与血管腔内修复偏好性研究（PROVE - AAA）试验旨在确定一种经过验证的决策辅助工具的有效性，以使患者偏好与最终修复方式更好地匹配。我们试图确定影响退伍军人选择腹主动脉瘤血管腔内修复术（EVAR）或开放手术修复术（OSR）决策的关键因素。
PROVE - AAA试验中的235名退伍军人被询问了有关修复的信息来源、就业状况和首选干预措施。使用传统内容分析法对答案进行编码和分析，以生成不重叠的主题，然后按就业状况进行分层。
42名患者（占入组者的17.8%）在使用决策辅助工具之前提供了他们关于OSR的信息来源。81%的退休退伍军人年龄大于70岁，而非退休退伍军人中这一比例为58%（P = 0.003）。最常见的信息来源是血管外科医生/专业人员或未指明的医生/其他卫生专业人员（51.4%），而该群体之外的信息来源占其余的48.5%。最首选的手术方式是EVAR。然而，未退休的个体更倾向于OSR。在提供EVAR信息来源的患者中，关于信息来源和首选手术方式的数据与之相似。
PROVE - AAA研究中的退伍军人更有可能已退休，并且在选择EVAR时更有可能依赖未指明的医生/其他卫生专业人员提供的信息。尽管退休和未退休的退伍军人都最倾向于EVAR，但未退休的退伍军人尽管更年轻却更倾向于OSR。
