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  1. Article ; Online: End of Life and Palliative Care For Patients With Peripheral Arterial Disease: A Systematic Review and Survey of Vascular Specialists' Perceptions of Prognosis and Death.

    McIntosh, Shona / Harding, Sam / Coughlin, Patrick A / Twine, Christopher P

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

    2023  Volume 65, Issue 3, Page(s) 453–454

    MeSH term(s) Humans ; Palliative Care ; Attitude of Health Personnel ; Peripheral Arterial Disease ; Death ; Prognosis
    Language English
    Publishing date 2023-01-20
    Publishing country England
    Document type Systematic Review ; Letter ; Comment
    ZDB-ID 1225869-6
    ISSN 1532-2165 ; 1078-5884
    ISSN (online) 1532-2165
    ISSN 1078-5884
    DOI 10.1016/j.ejvs.2023.01.027
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    Zs.A 2283: Show issues Location:
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  2. Article ; Online: An Assessment of Available Information on the World Wide Web for Patients with Lower Limb Arterial Disease.

    Dar, Than / Chowdhury, Mohammed M / Coughlin, Patrick A

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

    2021  Volume 61, Issue 4, Page(s) 620–627

    Abstract: Objective: The quality of patient information relating to intermittent claudication (IC) and peripheral arterial disease (PAD) on the World Wide Web was assessed.: Methods: The quality of websites and YouTube videos was assessed using the search ... ...

    Abstract Objective: The quality of patient information relating to intermittent claudication (IC) and peripheral arterial disease (PAD) on the World Wide Web was assessed.
    Methods: The quality of websites and YouTube videos was assessed using the search terms "intermittent claudication" and "peripheral arterial disease". The first 50 hits screened for each search term from the three largest search engines by market share, and the first 20 videos from YouTube were screened. Website quality was scored using the University of Michigan Consumer Health Website tool (maximum score 80). Readability was calculated using the Flesch Reading Ease (FRE) score (maximum score 100). Videos were classified by content and upload source. Video reliability was assessed using the JAMA benchmark criteria. Video educational content was assessed using the Global Quality Score (GQS). Subjective content assessment was undertaken.
    Results: Seventy-six websites were analysed. The majority of websites for both IC (51.7%) and PAD (72.3%) were rated as weak. The median Michigan score for IC (27; interquartile range [IQR] 15, 32.5) was lower that the score for PAD (31; IQR 25.5, 38.8; p = .030). The majority of websites for both IC (69%) and PAD (68.1%) were rated as requiring an above average reading level. The overall median FRE score was 55.9 (IQR 46.6, 60.6) for IC and 55.3 (IQR 44.6, 59.3) for PAD. Twenty-two videos were analysed. Of the 14 videos evaluated as part of the PAD search, the median JAMA score was 2 (2 - 3), the median GQS score was 3 (3 - 3) and the evaluation of content score was 8.5 (7.25 - 11.5). The equivalent scores for the IC search were 2 (2 - 2), 3 (3 - 4), and 5.5 (5 - 8).
    Conclusion: The educational quality and reliability of information both in written and video form on the internet is low. Attention needs to focus on improving the quality of all forms of information delivery to allow proper advocacy for patients.
    MeSH term(s) Access to Information ; Consumer Health Information/standards ; Humans ; Information Dissemination ; Internet ; Lower Extremity/blood supply ; Medical Writing ; Patient Education as Topic/standards ; Peripheral Arterial Disease/diagnosis ; Peripheral Arterial Disease/physiopathology ; Peripheral Arterial Disease/therapy ; Quality Control ; Video Recording
    Language English
    Publishing date 2021-02-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 1225869-6
    ISSN 1532-2165 ; 1078-5884
    ISSN (online) 1532-2165
    ISSN 1078-5884
    DOI 10.1016/j.ejvs.2021.01.002
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  3. Article ; Online: Assessment of internet-based information on statin therapy.

    Kwan, Jing Yi / Stocco, Fabio / Scott, David J A / Bailey, Marc A / Coughlin, Patrick A

    European journal of cardiovascular nursing

    2023  Volume 23, Issue 2, Page(s) 115–121

    Abstract: Aims: The use of statin therapy is deemed to be controversial by mainstream media. Patients increasingly source medical information from the internet, and the use of statins is no exception. This study aims to determine the quality and educational ... ...

    Abstract Aims: The use of statin therapy is deemed to be controversial by mainstream media. Patients increasingly source medical information from the internet, and the use of statins is no exception. This study aims to determine the quality and educational content of statin-focused information on the internet and YouTube.
    Methods and results: 'Statin' was searched on Google, Yahoo!, Bing, and YouTube. The first 50 results obtained from each search engine and the first 20 YouTube videos were screened by two assessors. Websites were assessed using the Flesch Reading Ease (FRE) score, University of Michigan Consumer Health Website Evaluation Checklist, and a customized scoring system evaluating statin-focused content for quality. Videos were scored using the Journal of the American Medical Association (JAMA) benchmark criteria, Global Quality Score (GQS), and the customized scoring system. Websites scored a median FRE score of 57.5 [interquartile range (IQR) 52.1-62.3], median Michigan score of 36 (IQR 32-41.5), and median content score of 5 (IQR 3.75-7). Good interobserver agreement was demonstrated [Michigan score interobserver coefficient correlation (ICC) = 0.968; content score ICC = 0.944]. Videos scored a median JAMA score of 2, median GQS score of 2.5, and median content score of 2.5. Good interobserver agreement was demonstrated (JAMA ICC = 0.746; GQS ICC = 0.874; content score ICC = 0.946).
    Conclusion: Quality and readability of statin-focused online information are poor. Healthcare professionals should be aware of the limitations of the current available sources and design online resources that are accurate and patient-friendly.
    MeSH term(s) United States ; Humans ; Consumer Health Information/methods ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Internet ; Comprehension
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Language English
    Publishing date 2023-06-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 2151245-0
    ISSN 1873-1953 ; 1474-5151
    ISSN (online) 1873-1953
    ISSN 1474-5151
    DOI 10.1093/eurjcn/zvad061
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5938: Show issues Location:
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  4. Article ; Online: Patient and Institutional Costs of Failure of Angioplasty of the Superficial Femoral Artery.

    Zielinski, Lukasz Piotr / Chowdhury, Mohammed M / Coughlin, Patrick A

    Annals of vascular surgery

    2020  Volume 72, Page(s) 218–226

    Abstract: Background: Debate surrounds the optimal management of superficial femoral artery (SFA) disease. Randomized trial data rarely reflect real world findings, specifically the consequences to the patient of angioplasty failure. We observed the effect of a ... ...

    Abstract Background: Debate surrounds the optimal management of superficial femoral artery (SFA) disease. Randomized trial data rarely reflect real world findings, specifically the consequences to the patient of angioplasty failure. We observed the effect of a failed SFA angioplasty on the need for repeated clinic visits, hospital readmissions, imaging requirements, and reinterventions.
    Methods: We reviewed a consecutive series of 148 patients (94 men, median age 72 years) undergoing solely SFA angioplasty over a 2-year period. Patient preangioplasty demographics and 2-year post-PTA follow-up data were collated, including hospital attendances (inpatient/outpatient), further imaging (including radiation exposure) and revascularization attempts. We defined "failed angioplasty" as presence of clinical symptoms with radiological evidence of significant restenosis after an initial successful primary SFA angioplasty.
    Results: Fifty-four patients represented with a failed angioplasty (median time of 4 months after index PTA). In this group, failure of index angioplasty resulted in a further 185 restenosis-related clinic visits and a total of 537 bed days of inpatient stay. This group underwent a further 149 imaging events and required a further 34 endovascular revascularization procedures and 12 infrainguinal bypass procedures. These interventions and investigations corresponded to overall effective radiation dose across all patients of 190.69 mSv. Of the cohort of 99 patients who did not have a "failed angioplasty," they required 100 clinic visits, 21 further scans (total radiation dose 6.42 mSv), and 36 bed days of inpatient admission.
    Conclusions: Failed angioplasty results in significant additional consequences for patients and health-care systems. Further work should focus on refining decision-making, providing the right procedure to the right patient at the right time.
    MeSH term(s) Aged ; Aged, 80 and over ; Angioplasty/adverse effects ; Angioplasty/economics ; Clinical Decision-Making ; Female ; Femoral Artery/diagnostic imaging ; Health Expenditures ; Hospital Costs ; Humans ; Male ; Patient Readmission/economics ; Peripheral Arterial Disease/diagnostic imaging ; Peripheral Arterial Disease/economics ; Peripheral Arterial Disease/therapy ; Recurrence ; Retreatment/economics ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Failure
    Language English
    Publishing date 2020-09-01
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2020.08.106
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2882: Show issues Location:
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  5. Article ; Online: Effects of Statin Therapy and Dose on Cardiovascular and Limb Outcomes in Peripheral Arterial Disease: A Systematic Review and Meta-analysis.

    Sofat, Samick / Chen, Xiaoyu / Chowdhury, Mohammed M / Coughlin, Patrick A

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

    2021  Volume 62, Issue 3, Page(s) 450–461

    Abstract: Objective: Statin therapy is indicated in patients with peripheral arterial disease (PAD). National Institute for Health and Care Excellence guidelines suggest the use of "high intensity" statins, although evidence with PAD specific data are lacking. ... ...

    Abstract Objective: Statin therapy is indicated in patients with peripheral arterial disease (PAD). National Institute for Health and Care Excellence guidelines suggest the use of "high intensity" statins, although evidence with PAD specific data are lacking. The effect of statin therapy and dose on outcomes in PAD is investigated.
    Data sources: Studies measuring statin use in PAD patients and outcomes were identified based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The EMBASE and MEDLINE databases were interrogated from January 1957 until February 2020. Twenty-two observational cohort studies and two randomised control trials were included (n = 268 611).
    Review methods: Pooled estimates of dichotomous outcome data were calculated using the odds/hazard ratios (OR/HR) and 95% confidence interval (CI). Meta-analysis was conducted using the inverse variance or Mantel-Haenszel method. Outcomes included all cause mortality (ACM), cardiovascular mortality (CVM), major adverse cardiac events (MACE), and amputation. Subgroup analysis was performed on studies comparing patients taking high dose vs. combined low and moderate doses of statins. The GRADE criteria assessed the quality of evidence for outcomes.
    Results: Statin therapy (vs. no statins) was significantly protective for ACM: OR 0.68 (95% CI 0.60 - 0.76) (number needed to treat [NNT] = 48), HR 0.74 (95% CI 0.70 - 0.78) (NNT = 10 - 91); MACE: OR 0.84 (95% CI 0.78 - 0.92) (NNT = 53), HR 0.78 (95% CI 0.65 - 0.93) (NNT = 167); and amputations: OR 0.59 (95% CI 0.33 - 1.07) (NNT = 333), HR 0.74 (95% CI 0.62 - 0.89) (NNT = 50). High doses of statins (vs. combined low and moderate doses) were significantly better protective against ACM OR 0.69 (95% CI 0.43 - 1.09) (NNT = 17), HR 0.74 (95% CI 0.62 - 0.89) (NNT = 16 - 200) but work less significantly for MACE OR 0.77 (95% CI 0.49 - 1.21) (NNT = 25). Amputations were less frequent in patients on high doses HR 0.78 (95% CI 0.69 - 0.90) (NNT = 53 - 1 000).
    Conclusion: Higher dosing of statins confers a significant improvement in patient outcomes, especially ACM and amputations, although the quality of the evidence was variable. Such findings require confirmation in larger, PAD specific trials.
    MeSH term(s) Aged ; Aged, 80 and over ; Amputation ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/mortality ; Cardiovascular Diseases/prevention & control ; Cause of Death ; Dyslipidemias/diagnosis ; Dyslipidemias/drug therapy ; Dyslipidemias/mortality ; Female ; Heart Disease Risk Factors ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Male ; Middle Aged ; Peripheral Arterial Disease/diagnosis ; Peripheral Arterial Disease/drug therapy ; Peripheral Arterial Disease/mortality ; Primary Prevention ; Risk Assessment ; Secondary Prevention ; Treatment Outcome
    Chemical Substances Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Language English
    Publishing date 2021-08-10
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 1225869-6
    ISSN 1532-2165 ; 1078-5884
    ISSN (online) 1532-2165
    ISSN 1078-5884
    DOI 10.1016/j.ejvs.2021.05.025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2283: Show issues Location:
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  6. Article ; Online: Frailty predicts poor longer-term outcomes in patients following lower limb open surgical revascularization.

    Kalyanasundaram, Asanish / Choy, Matthew / Kotta, Alekhya / Zielinski, Lukasz P / Coughlin, Patrick A

    The Journal of cardiovascular surgery

    2022  Volume 63, Issue 6, Page(s) 716–723

    Abstract: Background: Frailty in vascular surgery patients is increasingly recognized as a marker of poor outcome. This provides particular challenges for patients with lower limb peripheral arterial disease who require surgical revascularization. This study ... ...

    Abstract Background: Frailty in vascular surgery patients is increasingly recognized as a marker of poor outcome. This provides particular challenges for patients with lower limb peripheral arterial disease who require surgical revascularization. This study aimed to assess the impact of frailty on short- and long-term outcome in this specific patient group using a specialty specific frailty score.
    Methods: Patients undergoing open surgical revascularization for chronic limb ischemia (January 2015-December 2016) were assessed. Demographics, mode of admission, diagnosis, and site of surgery were recorded alongside a variety of frailty-specific characteristics. We calculated the previously validated Addenbrookes Vascular Frailty Score (AVFS) and Long AVFS (LAVFS). Primary outcome was 3-year mortality.
    Results: Two hundred and sixty-one patients (75% men, median age 69 years) were studied. The median length of stay was 6 days with a 3-year mortality of 23%. The predictive power of vascular frailty scores showed that for 3-year mortality, area under the receiver operator curve values (AUROC) were specific for both the AVFS score (AUROC: 0.724, 95% CI: 0.654-0.794) and LAVFS Score (AUROC: 0.741, 95%CI: 0.670-0.813). Furthermore, the cumulative AVFS and LAVFS scores both predicted mortality over the follow-up period (P=0.0001) with increased mortality among patients with higher scores.
    Conclusions: Incremental worsening of frailty, determined using a specialty specific frailty score, predicts mortality risk in patients undergoing lower limb surgical revascularization.
    Language English
    Publishing date 2022-09-28
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 80143-4
    ISSN 1827-191X ; 0021-9509
    ISSN (online) 1827-191X
    ISSN 0021-9509
    DOI 10.23736/S0021-9509.22.11895-1
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    Zs.A 469: Show issues Location:
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  7. Article ; Online: Assessment of Available Online Website and YouTube Resources for Patients with Abdominal Aortic Aneurysms.

    Stocco, Fabio / Kwan, Jing Yi / Sood, Mehak / Scott, D Julian A / Bailey, Marc A / Coughlin, Patrick A

    Annals of vascular surgery

    2023  Volume 96, Page(s) 176–185

    Abstract: Background: Over the last decade, patients have displayed a greater tendency to search for online information related to their health before seeking advice from a clinician. This study aims to determine the current quality and educational content of ... ...

    Abstract Background: Over the last decade, patients have displayed a greater tendency to search for online information related to their health before seeking advice from a clinician. This study aims to determine the current quality and educational content of online patient information for abdominal aortic aneurysms (AAAs).
    Methods: In March 2022, the 3 most popular search engines by market shares (Google, Yahoo!, and Bing) and the video platform YouTube were interrogated for the term "abdominal aortic aneurysm". Validated scoring tools were used to assess quality and readability of the top 50 results for each search engine and to evaluate reliability and educational quality of the first 20 YouTube videos returned by the search. A custom-made scoring system was used to assess content.
    Results: Forty-five unique websites were analysed, 29% of which held Health on the Net certification. Median Flesch-Kincaid Reading Ease (interquartile range [IQR]) was 56.4 (50.4-62.75), with the average website falling under the "difficult to read" category. Median Michigan score (IQR) was 38.5 (32-43.5), reflecting "weak" quality. Websites with a higher content-specific score had a significantly higher median Michigan score. Sixty percent of websites discussed benefits and risks related to AAA treatment, and only 31% discussed advantages and disadvantages of open versus endovascular treatment. No websites mentioned the volume-outcome relationship in aneurysm surgery. Eight unique YouTube videos were assessed. Median Journal of the American Medical Association score (IQR) was 2 (2-2.25). Median Global Quality Score score (IQR) was 3 (2-4). Median content score was 1 (0-2).
    Conclusions: The current average online information on AAA is of 'weak' quality and 'difficult' (i.e., above the standard reading ability of a 13- to 15-year-old) readability. Healthcare providers should focus on the provision of better AAA-focused patient information (e.g., appropriately referenced, regularly reviewed, and limiting advertisements where possible). The involvement of patient advisory groups during resource development is highly recommended.
    MeSH term(s) United States ; Humans ; Adolescent ; Reproducibility of Results ; Social Media ; Treatment Outcome ; Aortic Aneurysm, Abdominal/surgery ; Certification
    Language English
    Publishing date 2023-05-09
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2023.04.031
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2882: Show issues Location:
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  8. Article ; Online: Treat to Target Confers Enhanced Low Density Lipoprotein Cholesterol Reduction Compared With a Fire and Forget Approach in Patients With Intermittent Claudication.

    Sucharitkul, Penelope P J / Safdar, Nawaz Z / Bracewell, Bethany / Jain, Kinshuk / Coughlin, Patrick A / Bailey, Marc A

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

    2023  Volume 66, Issue 3, Page(s) 440–441

    MeSH term(s) Humans ; Cholesterol, LDL ; Intermittent Claudication/diagnosis ; Anticholesteremic Agents ; Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Chemical Substances Cholesterol, LDL ; Anticholesteremic Agents ; Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Language English
    Publishing date 2023-05-15
    Publishing country England
    Document type Letter
    ZDB-ID 1225869-6
    ISSN 1532-2165 ; 1078-5884
    ISSN (online) 1532-2165
    ISSN 1078-5884
    DOI 10.1016/j.ejvs.2023.05.017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Varicose veins in primary care.

    Atkins, Eleanor / Mughal, Nadeem A / Place, Fiona / Coughlin, Patrick A

    BMJ (Clinical research ed.)

    2020  Volume 370, Page(s) m2509

    MeSH term(s) Female ; Humans ; Male ; Pregnancy ; Primary Health Care/methods ; Varicose Veins/diagnosis ; Varicose Veins/physiopathology ; Varicose Veins/therapy
    Language English
    Publishing date 2020-07-07
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.m2509
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Cognitive Impairment in Vascular Surgery Patients: An Underestimated Issue.

    Mughal, Nadeem A / Gilder, Fay / Biram, Richard / Coughlin, Patrick A

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

    2020  Volume 61, Issue 2, Page(s) 333–337

    MeSH term(s) Aged, 80 and over ; Clinical Decision-Making/methods ; Cognitive Dysfunction/diagnosis ; Cognitive Dysfunction/etiology ; Cognitive Dysfunction/therapy ; Humans ; Male ; Palliative Care ; Perioperative Care/methods ; Postoperative Complications/diagnosis ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Vascular Surgical Procedures
    Language English
    Publishing date 2020-11-30
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 1225869-6
    ISSN 1532-2165 ; 1078-5884
    ISSN (online) 1532-2165
    ISSN 1078-5884
    DOI 10.1016/j.ejvs.2020.10.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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