Routine collection of patient reported outcomes in individuals with peripheral artery disease visiting a vascular specialty clinic: workflows, performance metrics, and clinical phenotypes

Abstract

Patient-reported outcomes (PROs) in peripheral artery disease (PAD) provide valuable insights when assessing meaningful health status improvement after intervention. This study implemented routine PRO workflows in a large academic PAD practice to assess feasibility expressed as completion rates and describe patient PRO profiles. Routine health status assessments using the Peripheral Artery Questionnaire (PAQ), VascuQoL-6, and EQ-5D were implemented (March 2021-July 2022) as a quality initiative for all patients with PAD at Yale’s outpatient interventional cardiology vascular clinic. Higher health status scores indicated better health status and quality of life. Scores were compared by initial visit type (new/pre-procedural vs. routine/post-procedural), and demographics (sex, race, and age < 65 vs. ≥65 years) using standardized differences ( d ), and minimally clinically important difference (MCID) benchmarks. Of 933 surveys distributed, 704 (75.5%) were completed by 411 patients whose initial visit was new/pre-procedural ( N = 95 patients) or routine/post-procedural ( N = 316 patients); 40.9% female, mean age 70.0 ± 11.3 years, 74.0% White, 14.8% Black/African American. New/pre-procedural patients had lower PAQ Summary scores than routine/post-procedural patients (54.6 ± 28.2 vs. 61.4 ± 27.5, d =-0.24), with clinically meaningful disparities (≥ MCID of 10) only in the routine/post-procedural group, where female and Black/African American patients reported worse scores. VascuQoL-6 scores showed no meaningful differences between visit types or demographics (all | d |<0.20). EQ-5D scores were similar between visit types ( d =-0.13) but demonstrated meaningful disparities (≥ MCID of 0.18), with younger new/pre-procedural patients and Black/African American routine/post-procedural patients reporting worse scores. Routine PRO assessment in high-volume PAD clinic was feasible and revealed meaningful health status disparities by sex, race, and age. These findings support targeted quality improvement and the development of benchmarks for meaningful post-intervention change.