Next Article in Journal
Psoas Abscess Due to Mycobacterium avium in a Patient with Chronic Lymphocytic Leukemia—Case Report and Review
Previous Article in Journal
Effects of Different Comorbidities on Health-Related Quality of Life among Respiratory Patients in Vietnam
Article Menu
Issue 2 (February) cover image

Export Article

Open AccessArticle
J. Clin. Med. 2019, 8(2), 215; https://doi.org/10.3390/jcm8020215

How the Results of a Randomized Trial of Catheter-Directed Thrombolysis versus Anticoagulation Alone for Submassive Pulmonary Embolism Would Affect Patient and Physician Decision Making: Report of an Online Survey

1
Department of Radiology, NYU Langone Health, New York, NY 10016, USA
2
Division of Cardiovascular Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
3
North American Thrombosis Forum, Brookline, MA 02445, USA
4
Department of Medicine, NYU Langone Health, New York, NY 10016, USA
5
Center for Vascular Emergencies, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
6
Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48109, USA
*
Author to whom correspondence should be addressed.
Received: 22 January 2019 / Revised: 4 February 2019 / Accepted: 5 February 2019 / Published: 7 February 2019
(This article belongs to the Section Nuclear Medicine & Radiology)
Full-Text   |   PDF [1385 KB, uploaded 8 February 2019]   |  

Abstract

The purpose is to investigate how the outcomes of a randomized controlled trial (RCT) of catheter-directed thrombolysis (CDT) versus anticoagulation alone for acute submassive PE would affect clinical decision-making. An online survey was sent to the Pulmonary Embolism Response Team Consortium members and the North American Thrombosis Forum members. Participants rated their preference for CDT on a 5-point scale in 5 RCT outcome scenarios. In all scenarios, subjects in the CDT group walked farther at 1-year than those in the anticoagulation group. A total of 83.3% of patients and 67.1% of physicians preferred CDT (score > 3) if it improved exercise capacity and did not increase bleeding. In every scenario, patients scored CDT higher than physicians (p < 0.05 for each). Bleeding and clinical deterioration were independently associated with the mean score. Patients’ age, gender, and history of PE did not influence CDT scores (p = 0.083, p = 0.071, p = 0.257 respectively). For patients, 60% > 60 years, 65.5% < 60 years, 57.1% of men, and 66.3% of women preferred CDT across scenarios. In conclusion, the majority of respondents would choose CDT if it improves long-term exercise capacity and does not increase bleeding. Patients appear to accept a higher bleeding risk than physicians if CDT improves long-term exercise capacity. View Full-Text
Keywords: pulmonary embolism; submassive; survey pulmonary embolism; submassive; survey
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Taslakian, B.; Li, C.; Goldhaber, S.Z.; Mikkelsen, K.Z.; Horowitz, J.M.; Kabrhel, C.; Barnes, G.D.; Sista, A.K. How the Results of a Randomized Trial of Catheter-Directed Thrombolysis versus Anticoagulation Alone for Submassive Pulmonary Embolism Would Affect Patient and Physician Decision Making: Report of an Online Survey. J. Clin. Med. 2019, 8, 215.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
J. Clin. Med. EISSN 2077-0383 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top