Key result
Surveys show ~42% of AAA patients prefer early surgery for a fast-growing small aneurysm.
Cross-Sectional (n=191)
Patients with AAA prioritize research into disease etiology and medical therapies to shrink aneurysms, and many are open to early surgery or clinical trials for fast-growing small AAAs.
Patient preferences may inform shared decisions for small AAAs but should not yet change practice; leaves open trials of medical therapies to shrink aneurysms.
BACKGROUND: The epidemiology of abdominal aortic aneurysm (AAA) is changing. Outcomes for aortic surgery have improved. Biomarkers of AAA progression are emerging. We recently reported the opinions of international vascular surgery colleagues regarding research and management for AAAs. This study aimed to ascertain a real-world patients' opinion regarding the same questions. METHODS: We administered a survey to patients with AAAs. We first ascertained their views on the priority topics for research in AAA. Using contemporary epidemiologic and surgical outcome data. We asked their preferences for different aspects of management in the hypothetical scenario where they had been diagnosed with a small (4 cm) AAA and a hypothetical biomarker predicted it to be fast growing. RESULTS: We received 191 responses from patient with AAAs (males 91%, median-age-group 75-79 years). Amongst the topics of research for AAA, the top priorities for research chosen by patients were: "discovering why AAA develops in a person" and "discovering new medications that can make an AAA shrink back to normal size". In the hypothetical scenario, 42% of patients would prefer to have surgery early, while they are younger and fitter. Fifty-two percent would follow the surgeon's recommendation as to whether to have early surgery or not. A high proportion of respondents would likely consider taking part in a clinical trial to test if early surgery in such a scenario will be beneficial. CONCLUSIONS: The results represent a snapshot of patient's views in terms of priorities for AAA research. We further demonstrate how patient's opinions can signpost the potential path for biomarker research to impact clinical practice.
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Lee et al. (2017) conducted a cross-sectional in Abdominal aortic aneurysm (AAA) (n=191). Survey on research priorities and management preferences was evaluated on Patient preferences for research topics and management of a hypothetical fast-growing small AAA. Among surveyed patients with abdominal aortic aneurysms, 42% preferred early surgery for a hypothetical fast-growing small AAA, while 52% would follow their surgeon's recommendation.
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