Burden Estimates and Temporal Patterns Associated with Peripheral Artery Disease

与外周动脉疾病相关的负担估计和时间模式

• 批准号: 8843676
• 负责人: Corey Andrew Kalbaugh
• 金额: $ 1.21万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-30 至 2015-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8843676
• 关键词: Burden; Estimates; Temporal; Patterns; Associated

DESCRIPTION (provided by applicant): Peripheral artery disease (PAD) is a prevalent atherosclerotic disorder characterized by plaque build-up in the lower extremities. Functional limitations resulting from PAD lead to poor quality of life, high health care utilization and costsof care, and an increase in mortality risk. Current estimates suggest that PAD affects 6.3% of Americans, including 20% of individuals age 65 years and older. A diagnosis of PAD suggests presence of atherosclerosis in other vascular beds, and PAD significantly increases the risk of coronary and cerebrovascular disease events. The direct and indirect contribution of this disease to the morbidity associated with other chronic disease conditions is important yet health professional and public awareness of PAD is low in comparison with awareness of other chronic cardiovascular diseases; up to 50% of those with PAD are unaware they have the disease and physicians often do not evaluate for the presence of PAD. Disease awareness is critical as the burden of PAD is expected to increase as our population ages. Most PAD reports likely underestimate PAD burden as published findings are largely based on hospitalized events, to the exclusion of the prevalent outpatient PAD clinical encounters. Information concerning the temporal patterns associated with PAD-related clinical care is likewise limited by the lack of research that would take into account events occurring in both the inpatient and outpatient settings. Thus, PAD is an understudied disease of public health significance. The aims of this proposed study are: to estimate the burden of clinically diagnosed PAD and its major subtypes and to estimate the temporal patterns associated with PAD-related clinical encounters from 2003-2012 using Center for Medicare and Medicaid Services (CMS) claims data available for all residents of four geographically defined US regions comprising the Atherosclerosis Risk in Communities (ARIC) Study, a large observational study of the etiology of atherosclerotic diseases. These claims will allow examination of PAD in the context of communities for which a wealth of information concerning comorbid conditions and other cardiovascular diseases exists. In the proposed research we will also take advantage of data from the ARIC Study cohort, which have been linked with CMS Medicare claims. We will use these two data sources to estimate the predictive value (i.e. calibration factors) of CMS Medicare claims in the identification of PAD We will use these calibration factors to calculate adjusted prevalence and incidence of PAD. Administrative claims provide extensive information on clinical encounters occurring in multiple clinical settings and, as such, constitute a rich resource for the examination of the epidemiology of PAD. Results of the proposed research will create a foundation for future studies aimed at comparing, by demographics and comorbid conditions, the different trajectories associated with clinically manifest PAD diagnosed in the inpatient or outpatient setting.

描述（由申请人提供）：外周动脉疾病（PAD）是一种普遍的动脉粥样硬化疾病，其特征是下肢斑块积聚。 PAD引起的功能局限性导致生活质量差，医疗保健利用率高和护理成本以及死亡率风险的增加。目前的估计表明，PAD会影响6.3％的美国人，其中包括65岁及以上的个人的20％。 PAD的诊断表明在其他血管床中存在动脉粥样硬化，并且PAD显着增加了冠状​​动脉和脑血管疾病事件的风险。这种疾病对与其他慢性疾病有关的发病率的直接和间接贡献很重要，但与对其他慢性心血管疾病的认识相比，健康专业人士和公众对PAD的认识较低。多达50％的有垫子的人没有意识到它们患有疾病，并且医生通常不会评估存在PAD。疾病意识至关重要，因为随着我们的人口年龄的增长，PAD的负担预计会增加。大多数PAD报告可能低估了PAD负担，因为已发表的发现很大程度上基于住院活动，以排除流行的门诊垫临床相遇。关于与PAD相关的临床护理相关的时间模式的信息同样受到研究的缺乏，这些研究会考虑到在住院和门诊环境中发生的事件。因此，PAD是一种研究的研究，具有公共卫生意义。这项拟议的研究的目的是：估算临床诊断垫的负担及其主要亚型的负担，并估算了使用Medicare和Medicaid Services中心（CMS）索赔可用的可用数据对于包括社区动脉粥样硬化风险（ARIC）研究的四个地理定义区域的所有居民，这是对动脉粥样硬化疾病病因的大量观察性研究。这些主张将允许在社区的背景下检查PAD，其中有大量有关合并症和其他心血管疾病的信息。在拟议的研究中，我们还将利用与CMS Medicare主张有关的ARIC研究队列中的数据。我们将使用这两个数据源来估计CMS Medicare主张的预测值（即校准因子）在识别PAD中，我们将使用这些校准因子来计算调整后的PAD的患病率和发病率。行政索赔提供了有关在多个临床环境中发生的临床遭遇的广泛信息，因此，构成了对PAD流行病学检查的丰富资源。拟议的研究的结果将为未来的研究创造一个基础，旨在通过人口统计和合并状况比较与住院或门诊环境中诊断的临床明显垫相关的不同轨迹。