Patients' opinions regarding research and management of abdominal aortic aneurysms.
Lee R., Jones A., Cassimjee I., Handa A.
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.