Dr. Meghan Brennan et al. recently conducted a study of a national cohort of veterans with type 2 diabetes who developed incident diabetic foot ulcers, and found that compared to early-stage ulcers, gangrene was increased with an increased risk of mortality over the next 1, 2, and 5 years. The authors also found that initial diabetic foot ulcer severity was a more significant predictor of subsequent death than diagnosed vascular disease, such as stroke, coronary artery disease, or peripheral arterial disease.
Diabetic Foot Ulcer Severity Predicts Mortality among Veterans with Type 2 Diabetes
Patient-Centered Outcomes Research: Brave New World Meets Old Institutional Policies
A recent article by PROKids team member Jessica Chung, et al., discusses the tensions between the engagement of patient stakeholders in research and the institutional and legal framework governing that engagement. Patient engagement during all stages of research has become increasingly common. Yet institutional policies, often intended to protect patients and research participants, are evolving to meet this new reality. Chung, et al. lays out these tensions using examples from trial funded by the Patient-Centered Outcomes Institute and led by Dr. Elizabeth Cox, Director of PROKids. Quandaries arose when the values or preferences of patient stakeholders conflicted with institutional policies about background checks, letters about privacy breaches, and study reminders.
Increasing Consumer Engagement by Tailoring a Public Reporting Website on the Quality of Diabetes Care
In a recent study, Dr. Maureen Smith et al. adapted a consumer-focused public reporting website to display diabetes quality reports tailored to the user's chronic conditions. Cognitive interviews with 20 individuals about the website suggested increased engagement from tailoring the site in three areas: the user's ability to interact, relevance, and feeling empowered to act.
The unchartered frontier: Preventive cardiology between the ages of 15 and 35
Risk factors for cardiovascular disease (CVD), such as atherosclerosis and lifestyle behaviors such as poor diet, begin in childhood and can progress through the adult years. A recent review co-authored by Dr. Heather Johnson emphasizes that in order to reduce the burden of CVD, it is important to not only treat risk factors in adolescents and young adults, but also to prevent those risk factors from developing in the first place. Methods to assess CVD risk and deliver cardiovascular preventive care to young adults are also discussed.
Family physician clinical compensation: Moving away from the RVU
In a recent article in Family Medicine, members of UW PATH describe the development and implementation of a population health-based physician compensation plan that shifted the focus away from relative value unit (RVU) productivity and towards panel management. Survey results from pre- and post-implementation showed that community physician satisfaction with the compensation structure rose from 33% to 74%, and satisfaction with the amount of compensation rose from 26% to 87%.