OPCM CAD
Please keep reading to learn more about the project on OPCM CAD that our team is currently involved with.
Project Overview
Project Title: Optimal Patient-Centered Management of Coronary Artery Disease (OPCM-CAD)
The selection of an optimal treatment strategy remains one of the most critical and challenging decisions in the management of patients with coronary artery disease (CAD). Current clinical practice guidelines recommend revascularization as optimal for patients with stable multivessel CAD. However, whether percutaneous or surgical revascularization or medical therapy is the optimal treatment for a patient is a challenging decision in many clinical scenarios, especially for the elderly, frail patients, and those living with multimorbidity who increasingly make up a larger proportion of patients identified with CAD in Canada.
Trade-offs in outcomes associated with different treatment options and variability in levels of accepted risk by both patients and providers are relevant to treatment decisions. However, strategies to incorporate this information into shared decision- making approaches are lacking in current clinical practice. To date, there has been limited investigation of patient preferences towards these treatment options and how they influence shared decisions for disease management in stable multivessel CAD. There is also a lack of prognostic tools designed to share outcomes under different treatment approaches with patients facing these decisions. The specific objectives of this study are to:
- characterize patient preferences towards CAD treatments to inform guideline recommendations and strategies to elicit these preferences to incorporate them into shared decision-making. This will be done by conducting an Alberta-wide survey of patients with coronary artery disease to understand their preferences towards medical management, angioplasty, and coronary artery bypass graft surgery for managing CAD.
- develop and validate risk prediction algorithms to predict individualized patient risks of mortality, readmissions for MI, unplanned revascularization, stroke, and kidney failure under different treatment strategies, so that the attributes of treatment decisions can be personalized and more effectively communicated to patients for shared decision-making. These algorithms will be trained using data from Alberta and validated in data from British Columbia.
- estimate net effects of the treatment options based on trade-offs in patient-important risks and benefits for adverse outcomes of patients to better understand when benefits of revascularization exceed risks for individual patients.
- develop an electronic clinical decision aid for that integrates patient preferences with the validated risk prediction algorithms and explores its feasibility for deployment at the point of care.
Support with funds from Alberta Innovates and the Canadian Institutes for Health Research, this study will advance our understanding of patient preferences towards these treatment options, and, ultimately, develop tools that can be used to communicate personalized risk information to patients to support shared decision-making for CAD management.
Research Team
This program brings together an interdisciplinary team of experts with extensive experience in risk prediction modeling, cardiovascular disease management, biostatistics, population data science, and knowledge translation.
| Principal Investigator | Title |
|---|---|
| Tolu Sajobi | Professor of Biostatistics, University of Calgary |
| Co-Principal Investigators | |
| Stephen Wilton, MD MSc | Associate Professor & Electrophysiologist, University of Calgary |
| Michelle Graham, MD MSC | Professor & Cardiologist, University of Alberta |
| Matthew James, MD PhD | Professor & Nephrologist, University of Calgary |
| Co-investigators | |
| Maria Santana, PhD | Professor & Patient-Centered Care Scientist, University of Calgary |
| Bryan Har, MD MSc | Interventional Cardiologist & Associate Professor, University of Calgary |
| Olu Awosoga, PhD PStat | Professor & Biostatistician, University of Lethbridge |
| Glen Hazlewood, MD MSc | Clinician Scientist & Professor, University of Calgary |
| Ricky Turgeon, PhD | Assistant Professor & Research Scientist, University of British Columbia |
| Colleen Norris, PhD RN | Professor of Cardiovascular Epidemiology, University of Alberta |
| Lisa Lix, PhD PStat | Professor of Biostatistics, University of Manitoba |
| Hude Quan, MD PhD | Professor & Health Services Research, University of Calgary |
| Teresa Kieser, MD | Professor & Cardiac Surgeon, University of Calgary |
| William Ghali, MD MSc | Professor & Vice President (Research), University of Calgary |
| Andrew McRae, MD, PhD, FRCPC | Associate Professor & Clinician Scientist, University of Calgary |
| Meng Wang, PhD | Biostatistician |
| Todd Wilson, PhD | Statistical Associate, APPROACH Research Group |
| Patient Advisors | |
| Ms. Winnie Pearson | |
| Ms. Sukhwant Parmar | |
| Mr. Ayotunde Kayode | |
| Mr. Gary Semeniuk |