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Decision Tree

Decision Tree. Colleen K. McIlvennan, DNP, ANP Assistant Professor of Medicine Section of Advanced Heart Failure and Transplantation INTERMACS 2016. Disclosures. None. Outline. What is Shared Decision Making? LVAD Therapy (DT) Decision Support Tools. 1. What is Shared Decision Making?.

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Decision Tree

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  1. Decision Tree Colleen K. McIlvennan, DNP, ANP Assistant Professor of Medicine Section of Advanced Heart Failure and Transplantation INTERMACS 2016

  2. Disclosures • None.

  3. Outline • What is Shared Decision Making? • LVAD Therapy (DT) • Decision Support Tools

  4. 1. What is Shared Decision Making?

  5. Shared Decision Making

  6. --Steve Wilkins, MPH

  7. Classes of Treatment Decisions Benefit When scientific evidence for benefit strongly outweighs harm, behavioral support (e.g. smoking cessation, beta-blocker) designed to describe, justify, and recommend is most appropriate. Risk

  8. Classes of Treatment Decisions Benefit LVAD 32F peri-partum CM INTERMACS 2 Risk

  9. Classes of Treatment Decisions Shared decision makingis most easily applied to preference-sensitive decisions, to help patients think through, forecast, and deliberate their options. Benefit Risk

  10. Classes of Treatment Decisions LVAD 75M multi-morbidity INTERMACS 5 Benefit Risk

  11. 2. DT LVAD Therapy

  12. McIlvennan, Magid, Ambardekar, Thompson, Matlock, Allen. Circ Heart Fail. 2015

  13. Dichotomy in Approach McIlvennan et al. Circ Cardiovasc Qual Outcomes. 2014

  14. Dichotomy in Approach McIlvennan et al. Circ Cardiovasc Qual Outcomes. 2014

  15. Explain and define the medically reasonable options Shared Decision-Making Process describe the risks, benefits, burdens of each option solicitation of patient preferences, values, goals

  16. 3. Decision Support Tools

  17. Decision Aids www.patientdecisionaid.org

  18. Thompson, Matlock, McIlvennan, Jenkins, Allen. JACC Heart Fail. 2015

  19. Thompson, Matlock, McIlvennan, Jenkins, Allen. JACC Heart Fail. 2015

  20. Controlled Patient Testimonials

  21. Future Directions • Ideal timing? • Does indication matter? • New technology

  22. Questions? colleen.mcilvennan@ucdenver.edu

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