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The My Pad Study For Patient Reported Outcomes For Peripheral Vascular Intervention In The Vascular Quality Initiative
Daniel Bertges, MD1, Matthew A. Corriere, MD, MS
2, Jessica P. Simons, MD, MPH
3, Yazan Duwayri, MD
4, Fedor Lurie, MD
5, Costantinos Constantinou, MD
6, Patrick Ryan, MD
7, Michael Stoner, MD
8, Benjamin S. Brooke, MD
9, Cassius I. Ochoa Chaar, MD, MPH, MS
10, Peter J. Rossi, MD
11, Jack L. Cronenwett, MD
12, Jens Eldrup-Jorgensen, MD
13.
1University of Vermont Medical Center, Burlington, VT, USA,
2The Ohio State University, Columbus, OH, USA,
3University of Massachusetts Chan Medical School, Worcester, MA, USA,
4Emory University Hospital, Atlanta, GA, USA,
5Jobst Vascular Institute, Toledo, OH, USA,
6My Michigan Health,, Midland, MI, USA,
7Nashville Vascular and Vein Institute, Nashville, TN, USA,
8University of Rochester Medical Center, Rochester, NY, USA,
9University of Utah Health, Salt Lake City, UT, USA,
10Yale University School of Medicine, New Haven, CT, USA,
1111. Froedtert and Medical College of Wisconsin, Milwaukee, WI, USA,
12Dartmouth Hitchcock Medical Center, West Lebanon, NH, USA,
13Tufts University School of Medicine, Boston, MA, USA.
OBJECTIVES: To conduct a multi-center pilot program, My Peripheral Arterial Disease (My PAD), for the collection of patient-reported outcomes (PRO) from patients undergoing peripheral vascular intervention (PVI) within the Vascular Quality Initiative (VQI).
METHODS: Ten centers within the Society for Vascular Surgery VQI PVI Registry collected health related quality of life (HR-QoL) surveys using a modified version of the Vascu-QoL 6 (VQ-6) and the EQ 5D-5L at three time periods; pre-operative, early follow-up (1-3 months), and late follow-up (9-15 months) from 4/1/2021 to 6/30/2024. A variety of workflows including automated emails to patients were employed. Survey completion rates and HR-QoL score changes were analyzed using paired Wilcoxon tests.
RESULTS: Among 5,845 eligible PVI procedures, 440 (7.5%) had a completed pre-operative PRO. Of the patients who filled out a pre-operative surveys, 247 (56.1%) had an early survey, and 104 (23.6%) completed all three time points. Successful collection of surveys varied across centers (pre-operative 0.2-29%, early follow-up 27-89% of pre-operative, late follow-up 5-60% of preoperative). Mean EQ-5D-5L scores significantly improved from pre-operative to early follow-up (- 2.7, P <0.01), and pre-operative to late follow-up (- 2.9, P <0.01) in the subset of 104 patients. VascuQoL-6 scores improved from pre-operative to early follow-up (+ 5.4, P <0.01), and pre-operative to late follow-up (+ 4.9, P <0.01). Meaningful improvements in VQ-6 scores were observed for patients with claudication (N=104) and CLTI (N=143) at early follow-up. No overall drop-off was observed at late follow-up (mean EQ-5D-5L + 0.5, P= 0.12 and VQ-6 - 0.6, P= 0.22).
CONCLUSIONS: The My PAD pilot study demonstrates that the collection of PROs in the form of health-related quality of life surveys is possible but challenging. Successful collection of PRO requires substantial resources and hands-on effort by motivated and dedicated vascular practices. PRO collection provided clinically meaningful insight with improvement in HR-QoL scores after endovascular revascularization. Future efforts should focus on supporting multimodal implementation including direct from patient data collection, integrated data collection within electronic medical records, and aligning financial incentives in effort to make patient-centered outcomes a routine part of PAD quality assessment.
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