Alicia Fernandez, MD
Acknowledgment: The author acknowledges Rachel Stern, BA, for insightful comments on earlier versions of this editorial.
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-1687.
Requests for Single Reprints: Alicia Fernandez, MD, Department of Medicine, University of California, San Francisco, Box 1364, San Francisco, CA 94143-1364; e-mail, firstname.lastname@example.org.
Fernandez A. Improving the Quality of Informed Consent: It Is Not All About the Risks. Ann Intern Med. 2010;153:342-343. doi: 10.7326/0003-4819-153-5-201009070-00011
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Published: Ann Intern Med. 2010;153(5):342-343.
Percutaneous coronary intervention (PCI) for stable coronary artery disease is one of the most common invasive procedures performed in the United States (1). Since the publication of the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) trial in 2007 (2), PCI is widely recognized to offer more immediate relief of angina than optimal medical therapy in stable patients with coronary artery disease, while conferring no additional benefit in the risk for myocardial infarction (MI) or death.
Try telling that to patients. In this issue, Rothberg and colleagues' provocative survey (3) of 153 patients who consented to elective angiography with possible simultaneous PCI at the discretion of the interventional cardiologist found that 88% believed that PCI would reduce their risk for MI and 82% believed that it would reduce their risk for death from MI. Their cardiologists did not agree. Most surveyed cardiologists believed, in accordance with trial data, that although PCI is effective at alleviating angina, it would not reduce nonfatal or fatal MI.
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Cardiology, Healthcare Delivery and Policy, Coronary Heart Disease, Percutaneous Coronary Intervention, Prevention/Screening.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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