Early Peripheral Vascular Intervention for Treating Patients with Claudication: A Decision Analysis using National Administrative Claims Data

Poster Number: P178
Presentation Time: 05:00 PM - 06:30 PM

Abstract Keywords: Clinical Decision Support, Surgery, Healthcare Quality
Primary Track: Applications
Programmatic Theme: Clinical Research Informatics

The objective of this study was to evaluate the impact of early peripheral vascular interventions (PVI) versus conservative management on the management of claudication in patients with peripheral arterial disease (PAD). Utilizing a decision model, we assessed the trade-offs between early PVI and conservative management considering various clinical outcomes. Data were obtained from Medicare fee-for-service claims, and probabilities were calculated based on patient encounters for claudication, PVI, open bypass, progression to Chronic Limb Threatening Ischemia (CLTI), and lower extremity amputation. A Markov model was constructed to simulate patient outcomes over a 2-year period.

Results indicated that patients undergoing early PVI experienced more PVIs and open bypass procedures compared to those receiving conservative management. Furthermore, the duration of time spent in a state of claudication was shorter for patients who underwent early PVI. These findings suggest that early PVI may not necessarily lead to improved outcomes and may even result in adverse effects, requiring additional interventions.

In conclusion, our study highlights the importance of leveraging healthcare informatics to inform decision-making processes in managing claudication among Medicare beneficiaries. By utilizing claims data and analytical methodologies, we can optimize resource allocation and promote evidence-based practices in healthcare delivery. These insights underscore the significance of integrating data-driven approaches to enhance patient care and outcomes in the management of PAD-related symptoms like claudication.

Speaker(s):
Chen Dun, MHS
Johns Hopkins University