Can we use patient reported factors to predict outcomes in CLTI

  • Research type

    Research Study

  • Full title

    Can Vascular-Specific patient reported factors predict clinical outcomes, guide case-selection for complex revascularisation and maximise cost-utility in Chronic limb-threatening ischaemia.

  • IRAS ID

    318307

  • Contact name

    Alun Davies

  • Contact email

    alun.davies1@nhs.net

  • Sponsor organisation

    Imperial College London

  • Duration of Study in the UK

    3 years, 0 months, 1 days

  • Research summary

    Extensive research tells us that patients with severe peripheral vascular disease (PVD) are more likely than the general population to have multiple medical problems, require extra help at home and be at risk of severe complications of their condition (Such as sepsis, heart attacks or requiring limb amputation).

    Vascular surgery deals with re-plumbing blocked or narrowed blood vessels to relieve pain and heal problematic ulcers. Traditionally the success of these types of surgery are measured by:
    • Survival (How long does the patient live after the operation?)
    • Limb loss (Does the patient require a limb to be amputated?)
    • Walking distance (How far is the patient able to walk without pain?)
    • Ankle-brachial pressure index or Toe pressures (A measurement of blood flow to the foot)

    Interestingly; there is no general consensus by experts on how to define successful treatment. Furthermore important patient factors are often neglected when evaluating or recommending treatment. Things that would be important to you may include:
    • What will my quality of life be like after an operation?
    • Will I be able to return to my home and live independently?
    • Will I require a carer or assistance with my activities?
    • Will I be able to sleep?
    • Will I be able to live pain free?

    Aims:
    This study aims to evaluate the patient factors which can be used to:
    1. Predict to outcomes of surgery
    a. Making recommendations on the type of surgery to use
    b. Making recommendations of who will and won’t benefit from surgery
    2. Understand which treatments are cost effective:
    a. Maximising the benefit to the patient for the money it costs the NHS.

    Patient Factors:
    We will specifically look at:
    1. How the patients quality-of-life changes over time and with different treatments
    2. How the patients perception of their illness effects their outcomes
    3. How the patients carer influences their outcomes
    4. How well doctors are able to accurately predict and communicate the risks of surgery
    5. How patients move through our service pathway (From initial referral to treatment)

  • REC name

    South Central - Oxford A Research Ethics Committee

  • REC reference

    22/SC/0457

  • Date of REC Opinion

    12 Jan 2023

  • REC opinion

    Further Information Favourable Opinion