Factors that impact the implementation of patient reported outcomes in routine clinical care for peripheral artery disease from the patient perspective.

Purpose: Patient reported outcome measures (PROMs) are well-suited for the longitudinal assessment of quality of life, including depression and physical limitations associated with peripheral artery disease (PAD) that are not routinely assessed in clinical care. This study was designed to gain the patient perspective to facilitate implementation of PROMs into clinical practice for PAD management.

Methods: Twenty-three patients with PAD at a single vascular surgery clinic were enrolled for a qualitative interview, July-December 2022.

Sex Differences in Patient-Reported Depression Following Vascular Surgery Procedures.

Introduction: Female patients frequently experience worse clinical outcomes than male patients after undergoing vascular surgery procedures. However, it is unclear whether these sex-based disparities also impact mental health outcomes. This study was designed to investigate sex differences in patient-reported outcome measures of depression for patients undergoing vascular surgery.

Long-term patient-reported outcomes among patients undergoing revascularization vs medical therapy for intermittent claudication.

Objective: Society for Vascular Surgery guidelines recommend revascularization for patients with intermittent claudication (IC) if it can improve patient function and quality of life. However, it is still unclear if patients with IC achieve a significant functional benefit from surgery compared with medical management alone. This study examines the relationship between IC treatment modality (operative vs nonoperative optimal medical management) and patient-reported outcomes for physical function (PROMIS-PF) and satisfaction in social roles and activities (PROMIS-SA).

Opioid tapering after surgery and its association with patient-reported outcomes and behavioral changes: a mixed-methods analysis.

Introduction: Opioid tapering after surgery is recommended among patients with chronic opioid use, but it is unclear how this process affects their quality of life. The objective of this study was to evaluate how opioid tapering following surgery was associated with patient-reported outcome measures related to pain control and behavioral changes that affect quality of life.

Methods: We conducted an explanatory sequential mixed-methods study at a VA Medical Center among patients with chronic opioid use who underwent a spectrum of orthopedic, vascular, thoracic, urology, otolaryngology, and general surgery procedures between 2018 and 2020.

Impact of frailty on risk of long-term functional decline following vascular surgery.

Objective: Frailty is a clinical syndrome associated with slow recovery after vascular surgery. However, the degree and length of functional impairment frail patients experience after surgery is unclear. The objective of this study was to prospectively measure changes in functional status among frail and non-frail patients undergoing a spectrum of different vascular surgery procedures.

Complete opioid cessation after surgery improves patient-reported pain measures among chronic opioid users.

Background: Preoperative chronic opioid use is common, but it is unclear whether complete opioid tapering can be achieved postoperatively without adversely affecting pain control and quality of life. This study was designed to assess the association between complete opioid tapering after surgery and patient-reported outcomes for pain intensity and pain interference.

Methods: We identified chronic opioid use patients undergoing a spectrum of nonemergency surgical procedures at a single Veterans Affairs medical institution between December 2017 and 2021.

Patient-reported physical function as a preoperative predictor of recovery after vascular surgery.

Objective: Preoperative risk assessment in vascular surgery often relies on the clinical subjectivity of providers and assessment tools with poor discrimination. Patient-reported outcome measures (PROMs) may provide a more objective assessment of an individual's own health status before surgery and ability to recover after a vascular procedure. We designed this study to determine whether PROMs assessed for physical function (PROM-PF) prior to vascular surgery could be used to predict patient risk for postoperative complications and delayed recovery.

Long-Term Functional Decline Following Vascular Surgery Among Vulnerable Adults.

Background: Identification of high-risk patients that may experience functional decline following surgery poses a challenge to healthcare providers. The Vulnerable Elders Survey (VES-13) is a patient-reported tool designed to identify risk for health deterioration based on age, self-rated health, physical function, and functional disabilities. This study was designed to determine whether VES-13 could predict long-term functional decline among patients undergoing vascular surgery procedures.

Patient-Surgeon Agreement in Assessment of Frailty, Physical Function, & Social Activity.

Background: The shared decision-making process between surgical providers and patients relies on a joint understanding about the risks of different treatment options based on a patient's individual health state. However, it is unclear whether a patient's perception of their own condition is congruent with the health state assigned by their surgical providers. This study was designed to compare provider assessment of frailty versus patient-reported outcome (PRO) measures of their own frailty status, physical function, and social activity level.

Proof of Principle that Molecular Modeling Followed by a Biophysical Experiment Can Develop Small Molecules that Restore Function to the Cardiac Thin Filament in the Presence of Cardiomyopathic Mutations.

This article reports a coupled computational experimental approach to design small molecules aimed at targeting genetic cardiomyopathies. We begin with a fully atomistic model of the cardiac thin filament. To this we dock molecules using accepted computational drug binding methodologies.