[Skip to Navigation]
Invited Commentary
April 2017

Assessing the Utility of Transcatheter Aortic Valve Replacement

Author Affiliations
  • 1Division of Cardiology, Department of Medicine, Duke Clinical Research Institute, Duke University, Durham, North Carolina
JAMA Cardiol. 2017;2(4):416-417. doi:10.1001/jamacardio.2016.5549

Saving lives is a noble and worthy endeavor, yet the goal of health care is also to alleviate symptoms and improve the quality of remaining years of life.1 In medicine, our compelling drive to improve survival has left us with a more primitive grasp on symptom and quality-of-life (QOL) outcomes. Quantifying patient-reported outcomes is challenging, because symptoms wax and wane and are subject to variation in reporting and recall. Symptoms often defy precise attribution to underlying cause. In the clinic setting, symptom assessment varies across clinician and patient, and in research, patient-reported outcomes are a tertiary concern. However, nowhere is a scientific approach to symptom assessment more relevant than for those in their mid-80s with severe aortic stenosis (AS) who report symptoms severely limiting their enjoyment of life. In these sick, symptomatic patients, symptomatic improvement is the primary goal of care. Research in the population undergoing transcatheter aortic valve replacement (TAVR) has enlightened our understanding of just how important standardized and complete patient-reported outcomes can be to informing decision making in this setting.

Add or change institution