PMID- 19110139
OWN - NLM
STAT- MEDLINE
DCOM- 20090205
LR  - 20081226
IS  - 1532-8511 (Electronic)
IS  - 1052-3057 (Linking)
VI  - 18
IP  - 1
DP  - 2009 Jan
TI  - Thrombolytic treatment for stroke: patient preferences for treatment, 
      information, and involvement.
PG  - 17-22
LID - 10.1016/j.jstrokecerebrovasdis.2008.06.009 [doi]
AB  - BACKGROUND: Thrombolytic treatment for stroke carries the potential for a better 
      functional outcome, but also a risk of intracranial hemorrhage and death. 
      Ideally, the decision to treat should be based on the patient's preferences. 
      METHODS: Study participants were 75 stroke survivors and 75 healthy, age-matched 
      control subjects. We used the Standard Gamble method to elicit utility values for 
      various stroke outcomes. We also assessed patients' preferences for: (1) 
      thrombolytic treatment; (2) the format of information on effects of treatment; 
      and (3) involvement in the decision-making process. RESULTS: Overall, the median 
      utility values were 0.93 (interquartile range [IQR] 0.90-0.96) for a mild stroke, 
      0.77 (IQR 0.65-0.85) for a moderately severe stroke, and 0.10 (IQR 0.05-0.20) for 
      a severe stroke. Stroke survivors assigned significantly higher utility values 
      than control subjects, as did participants older than 80 years and those who 
      lived with a partner (P < .01). When participants were given the estimates of 
      treatment effect and risk, 9% would have accepted thrombolytic treatment for a 
      mild stroke, 87% for a moderately severe stroke, and 97% for a severe stroke. A 
      majority of the participants (93%) wished to receive detailed information on 
      risks and benefits of thrombolysis, and most (91%) preferred shared 
      patient-doctor decision-making. CONCLUSIONS: Preferences for thrombolytic 
      treatment generally increase with increasing stroke severity, but individual 
      factors, such as previous stroke, advanced age, and living conditions can 
      influence the patient's decision. Most patients wanted precise information on the 
      treatment's risks and benefits, and preferred to be actively involved in the 
      decision-making process.
FAU - Slot, Karsten Bruins
AU  - Slot KB
AD  - Department of Internal Medicine, Ullevaal University Hospital, Oslo, Norway. 
      karsten.bruins.slot@medisin.uio.no
FAU - Berge, Eivind
AU  - Berge E
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Stroke Cerebrovasc Dis
JT  - Journal of stroke and cerebrovascular diseases : the official journal of National 
      Stroke Association
JID - 9111633
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Case-Control Studies
MH  - Choice Behavior
MH  - Decision Support Techniques
MH  - Female
MH  - *Health Knowledge, Attitudes, Practice
MH  - Humans
MH  - Male
MH  - Marital Status
MH  - Norway
MH  - *Patient Education as Topic
MH  - *Patient Participation
MH  - *Patient Satisfaction
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Stroke/*drug therapy
MH  - Survivors
MH  - *Thrombolytic Therapy/adverse effects
MH  - Treatment Outcome
EDAT- 2008/12/27 09:00
MHDA- 2009/02/06 09:00
CRDT- 2008/12/27 09:00
PHST- 2008/04/14 00:00 [received]
PHST- 2008/05/21 00:00 [revised]
PHST- 2008/06/09 00:00 [accepted]
PHST- 2008/12/27 09:00 [entrez]
PHST- 2008/12/27 09:00 [pubmed]
PHST- 2009/02/06 09:00 [medline]
AID - S1052-3057(08)00149-3 [pii]
AID - 10.1016/j.jstrokecerebrovasdis.2008.06.009 [doi]
PST - ppublish
SO  - J Stroke Cerebrovasc Dis. 2009 Jan;18(1):17-22. doi: 
      10.1016/j.jstrokecerebrovasdis.2008.06.009.