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    Enhancing Patient Specific Outcomes by Improving Amputation Level Decision Making in Patients with Peripheral Artery Disease and/or Diabetes

    10/8/19 | 9:15 AM – 10:30 AM time

    Presenter

    Joseph Czerniecki, University of Washington (Seattle, USA), Seattle VA Medical Center (Seattle, USA)

    Michael Dillon, La Trobe University (Melbourne, Australia)

    Dan Norvell, CLiMB research center at the Seattle Veterans Administration (Seattle, USA)

    Session format
    Symposium
    Category
    Rehabilitation Medicine & Surgery
    Target audience
    Congress registrants only
    Session Chair

    Joseph Czerniecki

    Languages
    English
    Agenda

    Abstract

    Current health care practices emphasize the importance of providing “patient-centric” health care. That is, patients should be informed about the risks and benefits of different treatment options so that their decisions will best align with their outcome values and preferences. Patients with peripheral artery disease (PAD)/diabetes who require an amputation have been shown to want more information and to want to participate in amputation level decisions. High quality evidence communicated effectively to patients and their providers is critical to optimizing the decision-making process.

    One of the most challenging decisions to be made in this population is whether to have a limb sparing distal amputation or a transtibial amputation. Unfortunately, this decision is often informed by overly simplified or inaccurate information. Many believe that distal amputation is critical to the preservation of mobility, and that the primary benefit of transtibial amputation is to reduce the risk of wound failure and secondary amputation. The relative importance of these and other key outcomes to the decision is uncertain. An additional challenge is how to best communicate these risks in the context of this populations poor overall long-term survival.

    This symposium will present current research identifying the outcome priorities of patients who are facing dysvascular amputation, the value of patient decision aids in informing outcomes and personal outcome priorities, as well as, the role of decision support tools in informing surgeons about probable patient specific outcomes. Together they support shared decision making and improved outcomes for patients undergoing this life altering surgical procedure.

    Statement of the objective / learning objectives

    1. Understand the outcomes that are important to dysvascular amputees.
    2. The use of patient decision aids to inform amputation level selection.
    3. The use of decision support tools to predict specific amputation level outcomes.

    Simultaneous Interpretation

    Japanese

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