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PORTRAIT(外周动脉疾病治疗实践相关的以患者为中心的结局:研究轨迹):一项国际前瞻性外周动脉疾病研究的设计与原理概述

PORTRAIT (Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories): Overview of Design and Rationale of an International Prospective Peripheral Arterial Disease Study.

作者信息

Smolderen Kim G, Gosch Kensey, Patel Manesh, Jones W Schuyler, Hirsch Alan T, Beltrame John, Fitridge Rob, Shishehbor Mehdi H, Denollet Johan, Vriens Patrick, Heyligers Jan, Stone MEd Nancy, Aronow Herbert, Abbott J Dawn, Labrosciano Clementine, Tutein-Nolthenius Rudolf, A Spertus John

机构信息

From the Department of Biomedical & Health Informatics, University of Missouri Kansas City (K.G.S., J.S.); Saint Luke's Mid America Heart Institute, Kansas City, MO (K.G.S., K.G., N.S., J.S.); Department of Cardiology, Duke University School of Medicine, Durham, NC (M.P., S.J.); Department of Cardiology, University of Minnesota, Minneapolis (A.T.H.); Departments of Cardiology and Vascular Surgery, Queen Elisabeth Hospital, Adelaide, Australia (J.B., R.F., C.L.); Department of Cardiology, University Hospitals of Cleveland, OH (M.H.S.); Department of Medical Psychology, Tilburg University, The Netherlands (J.D.); Department of Vascular Surgery, St. Elisabeth Hospital, Tilburg, The Netherlands (P.V., J.H.); and Department of Cardiology, Rhode Island Hospital, Providence (H.A., D.A.).

出版信息

Circ Cardiovasc Qual Outcomes. 2018 Feb;11(2):e003860. doi: 10.1161/CIRCOUTCOMES.117.003860.

Abstract

BACKGROUND

Health status outcomes, including symptoms, functional status, and quality of life, are critically important outcomes from patients' perspectives. The PORTRAIT study (Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories) was designed to prospectively define health status outcomes and examine associations between patients' characteristics and care to these outcomes among those presenting with new-onset or worsened claudication.

METHODS AND RESULTS

PORTRAIT screened 3637 patients with an abnormal ankle-brachial index and new, or worsened, claudication symptoms from 16 peripheral arterial disease (PAD) specialty clinics in the United States, the Netherlands, and Australia between June 2, 2011, and December 3, 2015. Of the 1608 eligible patients, 1275 (79%) were enrolled. Before treatment, patients were interviewed to obtain their demographics, PAD symptoms and health status, psychosocial characteristics, preferences for shared decision-making, socioeconomic, and cardiovascular risk factors. Patients' medical history, comorbidities, and PAD diagnostic information were abstracted from patients' medical records. Serial information about patients' health status, psychosocial, and lifestyle factors was collected at 3, 6, and 12 months by a core laboratory. Follow-up rates ranged from 84.2% to 91%. Clinical follow-up for PAD-related hospitalizations and major cardiovascular events is ongoing.

CONCLUSIONS

PORTRAIT systematically collected serial PAD-specific health status data as a foundation for risk stratification, comparative effectiveness studies, and clinicians' adherence to quality-based performance measures.

CLINICAL TRIAL REGISTRATION

URL: https://www.clinicaltrials.gov. Unique identifier: NCT01419080.

摘要

背景

从患者角度来看,健康状况结局,包括症状、功能状态和生活质量,是极为重要的结局。PORTRAIT研究(外周动脉疾病治疗实践相关的以患者为中心的结局:调查轨迹)旨在前瞻性地界定健康状况结局,并在新发或症状加重的间歇性跛行患者中,研究患者特征与这些结局的治疗之间的关联。

方法与结果

PORTRAIT在美国、荷兰和澳大利亚的16家外周动脉疾病(PAD)专科诊所,于2011年6月2日至2015年12月3日期间,筛查了3637例踝臂指数异常且有新发或症状加重的间歇性跛行症状的患者。在1608例符合条件的患者中,1275例(79%)被纳入研究。治疗前,对患者进行访谈以获取其人口统计学信息、PAD症状和健康状况、心理社会特征、共同决策偏好、社会经济状况以及心血管危险因素。患者的病史、合并症和PAD诊断信息从患者病历中提取。核心实验室在3个月、6个月和12个月时收集患者健康状况、心理社会和生活方式因素的系列信息。随访率在84.2%至91%之间。与PAD相关的住院和重大心血管事件的临床随访正在进行中。

结论

PORTRAIT系统地收集了系列PAD特异性健康状况数据,作为风险分层、比较疗效研究以及临床医生遵循基于质量的绩效指标的基础。

临床试验注册

网址:https://www.clinicaltrials.gov。唯一标识符:NCT01419080。

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