Kabir, Nahid Afrose

Young, Vershawn Ashanti

Mandel, Debra

Vitale, Joe, 1953-

Bennett, Zoë, author

Ewumbue-Monono, Churchill, 1961-

Filmer, Deon, author

Chrétien, de Troyes, active 12th century

Chrétien, de Troyes, active 12th century

Scherer, Manual

Spencer, Scott, 1975-

Gaboury, Paul R

Aitken, Robert, 1917-2010

Khan, Shahnaz

Ehrlich, Walter, 1921-

Amit-Cohen, Irit

Rotenstreich, Nathan, 1914-1993

Increased attention has focused on shared decision-making (SDM) and use of decision aids for treatment decisions in cardiology. In this issue of JAMA Cardiology, Coylewright et al report the results of a rigorously performed pilot study on the use of a decision aid to facilitate SDM for patients with symptomatic severe aortic stenosis (AS) at high or prohibitive risk for surgery considered for transcatheter aortic valve replacement vs medical therapy. Comparisons were made between encounters before clinicians were trained to use a decision aid and the first and fifth encounters after a decision aid was used. The patient-clinician interactions were audio recorded and later coded by independent reviewers using a validated measure to assess SDM. This mixed-methods study found that SDM significantly improved in a stepwise manner from the initial usual care encounter (before use of a decision aid) to the first and then fifth encounters after implementation of the decision aid. Along with this improvement in SDM, patients (n = 35) demonstrated increased knowledge about their treatment choices and reported increased satisfaction in their care with no increase in decisional conflict. In contrast, clinicians (n = 6) reported that they believed they already engaged in SDM prior to use of the decision aid and, after multiple uses of the decision aid, believed patients did not understand or benefit from this tool. The disconnect between clinician and patient perspectives was sobering and has implications for the adoption of decision aids or other tools to facilitate SDM in the clinical setting. Notable limitations of the study, which are acknowledged by the authors, include (1) small sample size (of clinicians and patients); (2) the decision aid is most useful for the relatively smaller number of patients at high or prohibitive risk for surgery for whom transcatheter aortic valve replacement and medical therapy may both be reasonable options; and (3) the lack of diversity in the clinicians (all male), which reflects the current demographics of interventional cardiology and cardiac surgery.

This mixed-methods pilot study examines whether the repeated use of a decision aid by heart teams was associated with greater shared decision-making, along with improved patient-centered outcomes and clinicians’ attitudes about decision aids.

This Special Communication proposes a classification of patients with left-ventricular disease according to the severity of mitral regurgitation that is proportionate vs disproportionate to left-ventricular end-diastolic volume.

Dewey Library - PQ6653.E62 M6613 2020

Dewey Library - PQ7390.G773 D6613 2018

Dewey Library - PQ7070.C65 2018

With the arrest of Tehsin Akhtar, thought to be Indian Mujahideen (IM) commander of India operations, security agencies have netted another big fish in the fight against terror.

This week marks the centenary of a key attempt at defining and delimiting the India-China boundary in the eastern sector. The ‘McMahon Line’ was born on March 24, 1914.

The Congress manifesto is the polar opposite of policies pursued by UPA-II. It promises to undo measures that clogged the economy and make economic growth the "overriding priority".

As polls come closer arrows are flying thicker, faster, sharper. Some are of time-honoured design, others quite modern. Included in the first category is flaming a party leader as communal or dissing her for being in the Italians’ pocket.

Despite the series of protests leading up to the 2014 Fifa World Cup in Brazil, today's kick-off match between Brazil and Croatia in Sao Paulo should bring the focus back on action on the football pitch.

Castro, Peter, author

Cornish, Vaughan, 1862-1948

Webster, D. G., 1975-

Davis, John K., author

Australia. Parliament. Senate. Select Committee on Murray-Darling Basin Plan, author, issuing body

Gershwin, Lisa-Ann, author