OBJECTIVES: The objectives of this study were to: 1) evaluate, from a global perspective, the decision-making processes, roles of individuals involved, and physicians’ and administrators’ beliefs about future decision making for the adoption of cardiovascular devices and medical technologies; and 2) determine which clinical and health economic factors decision makers consider the most influential and what types of data they use when making decisions.   METHODS: We surveyed cardiovascular physicians and hospital administrators in the US, UK, Australia, France, Germany, and Japan using a web-based questionnaire.  Respondents were asked about their involvement in and opinions on the decision-making process in their institutions, and the role that clinical and economic data play in influencing decisions.  Chi-squared tests were used to test for statistical differences between physicians and hospital administrators (all countries combined) and across countries. RESULTS: The questionnaire was completed by 151 physicians and 154 administrators across the six countries with roughly 25 physicians and 25 hospital administrators responding from each.  Physicians, followed by hospital committees, were most frequently responsible for making decisions, but respondents believed influence would shift towards committees in the future.   Physicians (78%) and administrators (81%) believed costs would more heavily influence decisions in the next 5 years.  Approximately half of hospital administrators consulted economic data often when making device adoption decisions.  Use varied somewhat by country with most frequent use by both physicians and hospital administrators in the U.S., U.K., and Australia.  CONCLUSIONS: Physicians’ and hospital administrators’ roles in decision making for cardiovascular devices appear to be changing in many countries, with committees and administrators assuming more important roles.  While clinical data is most influential to the decision process, the impact of health economic data seems to be growing.