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Decisions about treatment of aortoiliac claudication: the current practice among Swedish vascular surgeons.

OBJECTIVE
To find out what information vascular surgeons consider before they decide on treatments for intermittent claudication.


SUBJECTS
25 randomly selected vascular surgeons who participate in the Swedish Vascular Registry.


METHOD
Interviews about what information and investigations the surgeons would need before they make recommendations for treatment of 6 test cases.


MAIN OUTCOME MEASURES
The pattern of numbers and types of questions and of recommendations for treatment.


RESULTS
Surgeons asked a median of five questions (range 0-13) before they came to a decision. Only 9% of those questions concerned the patients' preferences. Open surgery was recommended in 59 of the 150 consultations (39.3%), for some by none and for others by up to 80% of surgeons.


CONCLUSIONS
Vascular surgeons primarily consider the patient's history and physical findings when treating claudication. They pay little attention to the preferences of the patients. Vascular surgeons in Sweden differ considerably in their patterns of questioning and do not agree about the treatment of intermittent claudication in individual patients.