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Videos to reduce racial disparities in ICD therapy Via Innovative Designs (VIVID) trial: Rational, design and methodology.

Abstract：

BACKGROUND:Despite a higher prevalence of sudden cardiac death (SCD), black individuals are less likely than whites to have an implantable cardioverter defibrillator (ICD) implanted. Racial differences in ICD utilization is in part explained by higher refusal rates in black individuals. Decision support can assist with treatment-related uncertainty and prepare patients to make well-informed decisions. METHODS:The Videos to reduce racial disparities in ICD therapy Via Innovative Designs (VIVID) study will randomize 350 black individuals with a primary prevention indication for an ICD to a racially concordant/discordant video-based decision support tool or usual care. The composite primary outcome is (1) the decision for ICD placement in the combined video groups compared with usual care and (2) the decision for ICD placement in the racially concordant relative to discordant video group. Additional outcomes include knowledge of ICD therapy and SCD risk; decisional conflict; ICD receipt at 90 days; and a qualitative assessment of ICD decision making in acceptors, decliners, and those undecided. CONCLUSIONS:In addition to assessing the efficacy of decision support on ICD acceptance among black individuals, VIVID will provide insight into the role of racial concordance in medical decision making. Given the similarities in the root causes of racial/ethnic disparities in care across health disciplines, our approach and findings may be generalizable to decision making in other health care settings.

journal_name

Am Heart J

journal_title

American heart journal

authors

Thomas KL,Sullivan LT 2nd,Al-Khatib SM,LaPointe NA,Sears S,Kosinski AS,Jackson LR 2nd,Kutyifa V,Peterson ED

doi

10.1016/j.ahj.2019.10.011

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

59-67

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(19)30293-5

journal_volume

220

pub_type

杂志文章,多中心研究,随机对照试验

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