Data collection
A convenience sample of patients who previously underwent at least one ablation was recruited. A complete list of all patients undergoing ablation in the past 18 months was generated from the electronic health record by the clinical team. A researcher (MRT) contacted patients by phone and invited them to complete a one-time interview. During a phone interview, participants answered open-ended interview questions and questions from validated surveys, which the researcher recorded in the secure survey software, REDCap. A hospital interpreter service was used to facilitate recruitment and data collection with patients whose primary language was not English. A convenience sample of physicians, nurse practitioners (NPs), and physician assistants (PAs) working in electrophysiology at the hospital were invited to participate by email. Clinicians who agreed to participate joined a video conference in which they answered open-ended interview questions. Participants were recruited until theoretical saturation was reached.
One interviewer (MRT) conducted audio-recorded interviews with patients and clinicians over the phone or via video conference and took corresponding field notes. The interviewer followed a semi-structured interview guide which included topics structured by the adapted SDM framework. Participants were asked about their experiences with AF, general preferences when approaching medical decision-making, and aspects of the process of deciding to have an ablation including information provided, feelings of conflict and regret, and level of involvement of patients, caregivers, and clinicians. Participants also described preferences for the content, delivery, and format of a hypothetical decision aid for ablation. Different versions of the interview guide were used for patient and clinician participants, and the guide was iteratively refined as new themes emerged during data analysis. All sessions lasted 30-45 minutes, and were audio recorded and transcribed verbatim using a secure transcription service.