{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:31:00Z","timestamp":1787729460352,"version":"build-2784847793"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,3,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Treatment decisions for aortic valve replacement (\n              <jats:styled-content style=\"fixed-case\">AVR<\/jats:styled-content>\n              ) should be sensitive to patient preferences. However, we lack knowledge of patient preferences and how to obtain them.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We assessed the mortality risk patients were willing to accept when undergoing\n              <jats:styled-content style=\"fixed-case\">AVR<\/jats:styled-content>\n              by using the Standard Gamble method and aimed to show how this risk willingness was affected by level of disease burden. We report findings from 439 patients, aged &gt;18\u00a0years with severe aortic stenosis who were referred for evaluation of\n              <jats:styled-content style=\"fixed-case\">AVR<\/jats:styled-content>\n              to our institution. The vast majority of patients accepted a mortality risk regarded as high or prohibitive according to current guidelines. Of the 439 patients, 51% patients were willing to forego surgery with high mortality risk (8\u201350%) and 19% were willing accept a prohibitive mortality risk (&gt;50%) as defined in current guidelines. However, the risk willingness varied considerably. Acceptance of prohibitive risk willingness (&gt;50%) was associated with reporting of 3 to 5 different restricting symptoms, with an odds ratio of 4.07 (95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              1.56\u201310.59) opposed by increasing score on\n              <jats:styled-content style=\"fixed-case\">EuroQol<\/jats:styled-content>\n              \u2013Visual Analog Scale, with an odds ratio of 0.99 (95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              0.97\u20131.00). The poor ability to predict risk willingness based on available clinical variables and health status suggests that other factors may be important advocating the need for tools for soliciting patient's preferences individually.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              When undergoing\n              <jats:styled-content style=\"fixed-case\">AVR<\/jats:styled-content>\n              , patients were willing to accept considerably higher perioperative risk than what is considered acceptable in current guidelines and practice. Patient preferences varied considerably, and they should be directly assessed and taken into account in decision\u2010making and guidelines.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>\n              :\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/\">https:\/\/clinicaltrials.gov\/<\/jats:ext-link>\n              . Unique identifier:\n              <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n              01794832.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.115.002828","type":"journal-article","created":{"date-parts":[[2016,3,19]],"date-time":"2016-03-19T04:15:57Z","timestamp":1458360957000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Eliciting Patient Risk Willingness in Clinical Consultations as a Means of Improving Decision\u2010Making of Aortic Valve Replacement"],"prefix":"10.1161","volume":"5","author":[{"given":"Amjad I.","family":"Hussain","sequence":"first","affiliation":[{"name":"Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Garratt","sequence":"additional","affiliation":[{"name":"Knowledge Center for the Health Services, Norwegian Institute for Public Health, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathrine","family":"Brunborg","sequence":"additional","affiliation":[{"name":"Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svend","family":"Aakhus","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway"},{"name":"Faculty of Medicine, University of Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Gullestad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjell I.","family":"Pettersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000031"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200017020-00004"},{"key":"e_1_3_3_4_2","first-page":"207","article-title":"The standard gamble method: what is being measured and how it is interpreted","volume":"29","author":"Gafni A","year":"1994","unstructured":"Gafni A. 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