Key result
Patients prioritize avoiding future disability while doctors place greater weight on death and hospitalization.
Why the study?
The potential gap in the perception and relative importance of cardiovascular outcomes between patients and doctors has been scarcely explored, with prior evidence reporting only views of either group alone in aggregate.
Do patients' and doctors' perceptions about the importance of cardiovascular outcomes coincide?
Cross-Sectional (n=337)
Yes
Do patients' and doctors' perceptions about the importance of cardiovascular outcomes coincide?
Simultaneous assessment reveals significant discordance between patients and physicians regarding the importance of major cardiovascular outcomes, emphasizing the need for shared decision-making.
OBJECTIVES: Cardiovascular (CV) diseases are associated with adverse outcomes. However, attention has typically focused on outcomes considered relevant by doctors, whereas the potential gap in perception and relative importance of outcomes that may exist between patients and doctors has been scarcely explored. Evidence available reports the views of either patients or doctors alone, and data are analysed in aggregate. We investigated this issue by surveying for the first time patients' and doctors' opinions simultaneously, on a one-to-one basis. DESIGN: Survey involving patients with different CV diseases. Each patient and their attending doctor were asked to simultaneously but independently gauge the importance each attached to a predetermined set of outcomes, filling out disease-specific questionnaires. Results were analysed by compositional analysis. SETTING: Inpatients and outpatients being seen by cardiologists and internal medicine specialists at hospitals affiliated with the National Health System in Umbria, Italy. PARTICIPANTS: All-comer patients, presenting with one of the following conditions: atrial fibrillation (AF), myocardial infarction (MI), heart failure (HF) or considered at high CV risk. MAIN OUTCOME MEASURES: Importance attached to outcomes relative to life path, quality of life, future clinical events. RESULTS: From 337 paired questionnaires returned, significant differences between patients' and doctors' perspectives emerged. Specifically: (1) patients with AF were significantly less concerned about the risk of stroke than doctors; (2) worsening of HF was a greater concern for doctors than patients, whereas patients weighed the risk of disability more; (3) patients with a previous MI, or at high CV risk, weighed the risk of hospitalisation less relevant than doctors, but were significantly more concerned about the risk of disability. CONCLUSIONS: Simultaneous, one-to-one assessment of patients' and doctors' opinion shows remarkable differences between patients' perception and physicians' judgement concerning the relevance of major CV outcomes. Appreciation and sharing of these issues may inform better tailoring of cardiac care.
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Spinucci et al. (2025) conducted a cross-sectional in Cardiovascular diseases (Atrial Fibrillation, Heart Failure, Myocardial Infarction, High Cardiovascular Risk) (n=337). Simultaneous one-to-one survey of patients and doctors vs. Doctors' perspectives vs. Patients' perspectives was evaluated on Difference in perceived importance of clinical outcomes (death, symptom worsening, hospitalisation, disability, bleeding, stroke) between patients and doctors. Simultaneous one-to-one surveys revealed significant differences in outcome prioritization, with patients significantly more concerned about future disability and doctors placing greater weight on clinical events like death and hospitalisation.
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