Impact of a Decision Aid on Patient Decision Making in Emergency Department Chest Pain Patients

Study Overview
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Brief Summary
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We are doing a study to assess the impact of including patients in making decision regarding their own medical care in the emergency department. We will randomly assign them to either receive a decision aid or usual care. In doing this, we aim to increase patient satisfaction and safely decrease medical cost.

Official Title
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Impact of a Decision Aid on Patient Participation in Decision Making and Resource Use in Low Risk Chest Pain Patients: A Randomized Trial

Conditions
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Acute Coronary Syndrome

Intervention / Treatment
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* Other: Decision Aid


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults with a primary complaint of chest pain. Treating clinician's next consideration is observation unit admission for cardiac stress testing. Exclusion Criteria: Initial cardiac troponin T value >99th percentile (>0.01ng/mL) History of coronary artery disease coronary revascularization procedure within the previous 30 days cocaine use within 72 hours by the clinician's initial history pregnancy patient cannot read English or have, in their clinician's judgment, major learning barriers, such as visual or hearing impairment or dementia that would compromise their ability to give written informed consent (or use the decision aid)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Decision Aid<br>Receives Decision Aid | Other: Decision Aid<br>* Chest pain choice decision aid<br>|
| No Intervention: Control<br>Patient receives usual care. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient knowledge | Patient knowledge regarding their short-term risk for an ACS and the risks of radiation exposure. | Immediately after patient visit | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of decision making process | Quality of the decision making process for the patient and clinician | Immediately after patient visit | 
| Satisfaction with decision aid | Patient and clinician acceptability and satisfaction with the decision aid | Immediately after patient visit | 
| Proportion of patients who decided to undergo observation unit admission and urgent cardiac stress testing | Proportion of patients who decided to undergo observation unit admission and urgent cardiac stress testing | During the initial ED visit | 
| Delayed or missed ACS | Rate of delayed or missed ACS | 30 days | 
| Economic costs and healthcare utilization | Economic costs and healthcare utilization | 30 days |