Understanding How Patients Fare
Insights Into the Health Status Patterns of Patients With Coronary Disease and the Future of Evidence-Based Shared Medical Decision-Making
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See Article by Sajobi et al
When I get diagnosed with obstructive coronary disease, and face a decision about whether to be treated medically, surgically, or percutaneously, I will want to know how I am likely to do—what my symptoms, function, and quality of life will be—with each treatment. I do not want to know the mean differences reported from clinical trials in which I would have likely been excluded, nor do I want to know what the guidelines say. What I want to know is how patients like me did, particularly with respect to their health status recovery, with each treatment. Only then will I have the information I need to make an informed decision as to whether the benefits of treatment warrant the risks.
This vision, first articulated by Paul Ellwood 40 years ago in his 1988 Shattuck lecture,1 through the current era of funding by the Patient-Centered Outcomes Research Institute,2 has been at the forefront of my research interests. Early in the course of my career I worked to develop the means to quantify the health status of patients with coronary disease by developing the Seattle Angina Questionnaire.3 …