APPROACH - Current projects

Current Projects

Since 1995, the APPROACH research group has completed a number of projects related to cardiac care across the province of Alberta.


Patient Reported Outcome Measures (PROMs) are multi-item survey instruments used to elicit patients’ direct evaluation of their health status and quality of life. PROMs are useful for predicting prognosis and use of acute care services. While PROMs are familiar as research tools, there is now a global movement to incorporate PROMs measurement and reporting into routine care. Mounting evidence shows this can lead to improved patient satisfaction and care quality. The IMPROVE CV project has three linked aims. 

AIM 1 – to implement an ePROM data collection for all patients undergoing invasive testing for CHD in Alberta and complete the development of a production version of our individualized physician-facing results reporting system. 

AIM 2 – to support patients and physicians with the implementation of ePROM by designing and testing educational programs for patients, families, and clinicians. These programs employ the evidence-based Capability – Opportunity – Motivation – Behaviour (COM-B) framework paired with HCD principles, and will include self-learning videos, group-based learning opportunities, and individual physician supports. 

AIM 3 – to conduct pilot testing of the individualized ePROM reporting tool within ambulatory cardiology care in Alberta using a pre-post design. Through this testing, we will assess uptake of the tools and compare patient and clinician perceptions of communication quality with and without ePROM tools. 


The selection of an optimal treatment strategy remains one of the most critical and challenging decisions in the management of patients with coronary artery disease (CAD). Current clinical practice guidelines recommend revascularization as optimal for patients with stable multivessel CAD. However, whether percutaneous or surgical revascularization or medical therapy is the optimal treatment for a patient is a challenging decision in many clinical scenarios, especially for the elderly, frail patients, and those living with multimorbidity who increasingly make up a larger proportion of patients identified with CAD in Canada. Tradeoffs in outcomes associated with different treatment options and variability in levels of accepted risk by both patients and providers are relevant to treatment decisions. However, strategies to incorporate this information into shared decision- making approaches are lacking in current clinical practice. To date, there has been limited investigation of patient preferences towards these treatment options and how they influence shared decisions for disease management in stable multivessel CAD. There is also a lack of prognostic tools designed to share outcomes under different treatment approaches with patients facing these decisions. This study will advance our understanding of patient preferences towards these treatment options, and, ultimately, develop tools that can be used to communicate personalized risk information to patients to support shared decision making for CAD management.