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Understanding Real-World Outcomes of Endovascular Treatment of Claudication

了解跛行血管内治疗的真实结果

基本信息

批准号：
10646204
负责人：
Nicholas Harold Osborne
金额：
$ 16.96万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-25 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10646204
关键词：
Affect American Amputation Angioplasty Atherectomy Award Behavior Blood Vessels Blood flow Blue Cross Blue Shield Cardiology Cardiovascular Diseases Cardiovascular system Caring Catheters Cessation of life Clinical Clinical Data Clinical Trials Comparative Effectiveness Research Complex Consensus Data Decision Making Development Diabetes Mellitus Diagnosis Disease Disparate Effectiveness Effectiveness of Interventions Fostering Future Goals Grant Health Personnel Heterogeneity Hospitalization Hospitals Intervention Interventional radiology Interview K-Series Research Career Programs Knowledge Limb structure Manuscripts Measures Medical Mentorship Michigan Motivation Myocardial Infarction Newly Diagnosed Operative Surgical Procedures Outcome Pain Patient Care Patients Perception Peripheral arterial disease Physicians Population Preparation Procedures Provider Qualitative Methods Qualitative Research Quality of Care Quality of life Recommendation Registries Reporting Research Research Methodology Research Personnel Research Proposals Specialist Statistical Methods Stents Structure Subgroup Surgeon Training Treatment Effectiveness Variant Veterans Health Administration Walking aged care delivery career development claudication cohort comorbidity comparative effectiveness cost implementation science improved improved outcome intervention effect longitudinal database medical specialties novel patient subsets public health relevance radiologist shared decision making skills theories treatment choice treatment comparison treatment effect treatment strategy

项目摘要

PROJECT SUMMARY/ABSTRACT Peripheral arterial disease (PAD), defined as narrowed blood vessels causing decreased blood flow to the extremities, is a common diagnosis, affecting nearly 1 in 5 Americans and costing more than $21 billion annually. Claudication (pain with walking) is the most common manifestation of PAD. The invasive treatment of PAD has risen rapidly despite a lack of evidence of the long-term effectiveness of these procedures. Without a full understanding of the long-term effectiveness of these treatments and the motivations of providers prescribing these treatments, decision-making remains unclear. Providing long-term data of the effectiveness of treatment strategies and why providers choose treatments will directly improve patient shared decision- making. The goal of this research proposal is to describe the long-term effectiveness of interventions for claudication and to explore the provider motivations for treatment decisions. The three aims of this proposal are: 1) Describe the long-term comparative effectiveness of interventions in the treatment of claudication, 2) Measure the heterogeneity of treatment effects of interventions for claudication, and 3) Identify the key motivators of physician practice by assessing provider perceptions of the effectiveness of medical therapy, open surgery and endovascular interventions. The first two aims will use novel clinically-rich data from the Veterans Health Administration to measure the comparative effectiveness of treatment strategies. The third aim will employ semi-structured interviews to explore provider perceptions of treatment effectiveness and motivations for treatment decisions. The proposed research and training will provide Dr. Osborne with the necessary skills to become a leader in comparative effectiveness research in cardiovascular disease and enhance shared decision-making. Dr. Osborne's career development will be fostered by the mentorship of a diverse interdisciplinary team. Training will include graduate level advanced didactic coursework in organizational management, behavior and theory, qualitative research methods and implementation science. He will acquire new skills in the preparation of manuscripts, and grantsmanship. This training will directly lead to his development into an independent investigator, aimed at improving the quality of care for patients with PAD. This career development award will provide the groundwork for further studies to develop strategies to decrease variation in care and improve the treatment of patients with PAD.

项目总结/文摘