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.