Left Ventricular Assist Device (LVAD) Patient Decision Aid


Page showing options, presenting probabilities, using statistics, and highlighting uncertainty. Because the majority of people without a left ventricular assist device (LVAD) die imminently, this option required unique framing regarding benefits, risks, and burdens.


We presented the LVAD (accepting) and no LVAD (declining) in a column format (Figure 3). The parallel contrast between the 2 options helped emphasize that DT LVAD is a choice. This reframing was important given the tendency of patients and caregivers to describe the LVAD as a Hobson’s choice, that is, a choice between something and nothing. The parallel framing concretely showed what the no-LVAD option might look like to facilitate viewing the situation as a dilemma, that is, a choice between 2 imperfect options. However, because patients who decline a DT LVAD have such a high mortality rate, presenting the risks and benefits of LVAD declination in a substantive way was a challenge.


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