Evidence map›Paper›PMID 34627781›Full record

ArticleThe American journal of medicine2022

Clinician Specialty, Access to Care, and Outcomes Among Patients with Peripheral Artery Disease.

E Hope Weissler, Cassie B Ford, Dennis I Narcisse, Steven J Lippmann, Michelle M Smerek, Melissa A Greiner, N Chantelle Hardy, Benjamin O'Brien, R Casey Sullivan, Adam J Brock and 4 more

Open access · greenAbstract read
In one paragraph

Article in The American journal of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 2 institutions in 1 country.

E Hope WeisslerDivision of Vascular and Endovascular Surgery, Duke University School of Medicine, Durham, NC. Electronic address: hope.weissler@duke.edu.
Cassie B FordDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC.
Dennis I NarcisseDivision of Cardiology, Duke University School of Medicine, Durham, NC.
Steven J LippmannDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC.
Michelle M SmerekDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC.
Melissa A GreinerDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC.
N Chantelle HardyDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC.
Benjamin O'BrienDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC.
R Casey SullivanDivision of Cardiology, Washington University School of Medicine, St. Louis, Mo.
Adam J BrockDivision of Cardiology, Duke University School of Medicine, Durham, NC.
Chandler LongDivision of Vascular and Endovascular Surgery, Duke University School of Medicine, Durham, NC.
Lesley H CurtisDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC; Clinical Research Institute, Durham, NC.
Manesh R PatelDivision of Cardiology, Duke University School of Medicine, Durham, NC; Clinical Research Institute, Durham, NC.
W Schuyler JonesDepartment of Population Health Sciences, Duke University School of Medicine, Durham, NC; Division of Cardiology, Duke University School of Medicine, Durham, NC; Clinical Research Institute, Durham, NC.
Duke University · USWashington University in St. Louis · US

Funding

Addressing variability in peripheral arterial disease outcomes using machine learning techniquesF32HL151181 · NHLBI · DUKE UNIVERSITY · PI WEISSLER, ELIZABETH HOPE · 2020 to 2021
$130k
NHLBI NIH HHS F32 HL151181
6 · The paper itself

Abstract

backgroundUnderstanding the relationship between patterns of peripheral artery disease and outcomes is an essential step toward improving care and outcomes. We hypothesized that clinician specialty would be associated with occurrence of major adverse vascular events (MAVE).

methodsPatients with at least 1 peripheral artery disease-related encounter in our health system and fee-for-service Medicare were divided into groups based on the specialty of the clinician (ie, cardiologist, surgeon, podiatrist, primary care, or other) providing a plurality of peripheral artery disease-coded care in the year prior to index encounter. The primary outcome was MAVE (a composite of all-cause mortality, myocardial infarction, stroke, lower extremity revascularization, and lower extremity amputation).

resultsThe cohort included 1768 patients, of whom 30.0% were Black, 23.9% were Medicaid dual-enrollment eligible, and 31.1% lived in rural areas. Patients receiving a plurality of their care from podiatrists had the highest 1-year rates of MAVE (34.4%, P <.001), hospitalization (65.9%, P <.001), and amputations (22.6%, P <.001). Clinician specialty was not associated with outcomes after adjustment. Patients who were Medicaid dual-eligible had higher adjusted risks of mortality (adjusted hazard ratio [HR

conclusionsClinician specialty was not associated with worse outcomes after adjustment, but certain socioeconomic factors were. The effects of clinician specialty and socioeconomic status were likely attenuated by the fact that all patients in this study had health insurance; these analyses require confirmation in a more representative cohort.

Indexed as

Healthcare DisparitiesHealth Services AccessibilityAgedCohort StudiesEndovascular ProceduresFemaleHospitalizationHumansInsurance, HealthLower ExtremityMaleMiddle AgedPeripheral Arterial DiseasePhysiciansProportional Hazards ModelsRisk FactorsHealth servicesPeripheral artery diseaseVascular medicineVascular surgery

Identifiers

PMID34627781
PMCPMC8840959
OpenAlexW3204187060

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.