Investing in Patient-Centered Research Since 1982
Driving Collaboration and Leveraging Resources
to Address Unmet Needs
Millions of Americans are currently living with some form of vascular disease, whether it’s something they were born with or developed at some point in their lives. Vascular disease is often overlooked and underfunded; high-quality research that improves patients’ lives is far from the norm. In other disease spaces that have these issues, we have seen the benefit of improving research for the patient by partnering with the patient. Patient-centered research is a process that focuses on the actual lived experiences, preferences, and needs of patients living with the disease/symptoms of interest. It brings patients into the research design, execution, analysis, and dissemination as partners whose contributions are valued and important for making sure the research actually serves and benefits the broader patient population.
Patient-centered research is lacking in the vascular disease space, and the Foundation to Advance Vascular Cures is committed to addressing this issue in several ways by:
Building capacity among patient and caregiver populations to understand, engage in, and advocate for patient-centered research
Raising awareness of the benefits of patient-centered research among researchers, providers, industry, and other stakeholders
Developing tools and resources to help train and prepare patients and researchers to conduct meaningful patient-centered research
Coordinating young professional and research-based grants that champion patient-centered research and patient-centered methodologies
Our dedication to patient-centered research includes bringing education and empowerment to underserved populations across the country, including minoritized groups. We strive to bring patient voices forward so that research better addresses their needs, and ultimately contributes towards better vascular health for all. Below are several examples of patient-centered research that we have either funded or participated in.
The 2022 Health Equity grants have been awarded to two teams of established clinician-scientists at leading academic medical centers and community health organizations.
The Collaborative Patient-Centered Research (CPCR) grant is designed to fill a critical funding gap by rewarding high-risk, collaborative science that prioritizes the patient perspective.
The new Vascular Health Impact Grant (VHIG) is designed to fill a critical funding gap by rewarding innovative and collaborative community-based initiatives.
2022 Health Equity Grants
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INVESTIGATORS:
· Emily Rosario, PhD — Director of Research at Casa Colina Hospital and Centers for Healthcare
· Tze-Woei Tan, MD — Vascular Surgeon at University of Arizona
· David G. Armstrong, DPM PhD — Podiatrist at USC and President of American Limb Preservation Society (ALPS)
· Virginie Blanchette, DPM PhD — University of Quebec at Trois-Rivieres
· Francisco N. – Patient advocate
PAD patients from low-income neighborhoods are at increased risk of developing a diabetic foot wound and leg amputation. Peer support can provide effective and culturally tailored social support and may improve the quality of life. The pilot project is testing whether patient-centered Peer-Pal Intervention (PPI) helps promote care of low-income patients with vascular disease and diabetic foot ulcerations.
Patients with peripheral artery disease from low-income neighborhoods are at increased risk of developing a diabetic foot wound and leg amputation. Foot and wound care is a significant challenge in low-income communities, and patients with foot ulcerations commonly experience emotional distress. Peer support can provide effective and culturally tailored social support and may improve the quality of life of low-income patients with diabetes. The pilot project is testing whether patient-centered Peer-Pal Intervention (PPI) helps promote care of low-income patients with vascular disease and diabetic foot ulcerations.
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INVESTIGATORS:
· Paul DiMuzio, MD, MBA, FACS (Co-PI) – Director of Division of Vascular and Endovascular Surgery and the William M. Measey Professor of Surgery at Jefferson University
· Ron Renzi, DPM (Co-PI) — Assistant Surgeon at Jefferson Health- Abington and Founder of Save Your Soles Podiatry
· Kathleen Reeves, MD (Co-I)—Chair and Professor of Urban Bioethics and Population Science at Temple University
This project will address health disparities in amputation rates among Black men in Philadelphia by engaging the entire community, including patients, community organizations and providers. The team will develop a provider webinar series of virtual vascular education and a “train-the-trainer” course for providers to address early recognition of peripheral artery disease (PAD). In partnership with community organizations, there will be free screening events and community outreach to bolster greater understanding of PAD, including risk factors, warning signs, and resources. Emphasizing patient experience in the evaluative strategy, the project team will enlist the expertise and insight of patients with personal experience with lower extremity amputation and vascular complications to provide a real-time view and perspective. The project will have expansive impact on the number of screenings conducted, early identification, and subsequently, limb preservation. Imperative to preventing lower extremity amputations, training will be offered to more providers within the Jefferson and Temple Health networks, targeting existing interventions related to equity in vascular care.
2021 Grant Awards
The 2021 CPCR grants were awarded to two teams of established clinician-scientists at four leading academic medical centers.
The grant funded 1-2-year projects that address the unmet needs related to patient-centered technology for harnessing & using data remotely in PAD and/or CLTI.
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INVESTIGATORS:
· Matthew A. Correire MD, University of Michigan· Oliver Aalami MD, Stanford University
· Diane Treat-Jacobson PhD RN, University of Minnesota
Patients with PAD often seek treatment to overcome leg pain that prevents them from performing a specific activity of daily life (like shopping, gardening, or going for a walk). Because healthcare providers usually categorize symptoms based on how long, how far, or how fast a patient can walk, it can be difficult to know whether treatment is likely to help the patient achieve their activity goal or improve their quality of life.
This project will collect symptom information from patients via surveys and their walking activity via a smartphone app. The results will link how healthcare providers measure PAD symptoms in clinic with how patients experience symptoms in their community. The goal is to address the gap between patient and healthcare provider perspectives on PAD symptoms, support more holistic treatment selection, and potentially develop new patient-reported outcomes based on activity-specific goals.
Results from Year 1 were presented at a Plenary session at the Vascular Annual Meeting in June 2022 and published in the Journal of Vascular Surgery. “Characterizing Patient-reported Claudication Treatment Goals to Support Patient-centered Treatment Selection and Outcomes Assessment Strategies”
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INVESTIGATORS:
· Jennifer Rymer MD, Manesh Patel MD, Schuyler Jones MD, Hope Weissler MD and Kevin Southerland MD, Duke University
· Jade Hiramoto MD, UCSF
Currently there are no health status instruments (standardized, validated questionnaires completed by patients to measure their perception of their functional well-being and health status) that have been validated or tested for use in patients with chronic limb-threatening ischemia (CLTI). The research group is interested in examining several common instruments that are currently used in patients with peripheral artery disease to determine how well they perform in patients with a severe form of PAD, CLTI.
The goal is to develop an increased understanding of how well these instruments perform in this subpopulation of patients, and which of them may be most useful to leverage in both research and clinical settings in the care and treatment of patients with CLTI.
2020 Grant Awards
The 2020 CPCR grants were awarded to two teams of established clinician-scientists at four leading academic medical centers, supported by a collaborative research laboratory and computational resources at UCSF.
The program’s goal is to identify biomarkers of poor response to procedures, to improve the patient prognosis and identify new targets for future drugs. Peripheral artery disease (PAD) and abdominal aortic aneurysms (AAA) cause significant disability and mortality. Improved technologies have enabled less-invasive treatments, but their long-term effectiveness is limited and new interventions are often necessary. Multiple studies suggest certain molecules in our blood influence vascular repair and may serve as biomarkers to predict a positive or negative outcome.
The impact on patient lives would be enormous if researchers could identify the biological factors (biomarkers) that predict the success or failure of these procedures for individual patients. The proposed projects would enable major progress toward the ultimate development of validated tests to predict this response.
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INVESTIGATORS:
· Edith Tzeng MD, UPMC (PI)
· John Curci MD, Vanderbilt University
Currently, AAA are treated surgically with endovascular aneurysm repair (EVAR) but approximately 25% of patients still have persistent AAA growth and remain at risk for rupture – fatal 90% of the time. The AAA project will enroll 80 patients over two years, and also collect blood samples and imaging data. -
INVESTIGATORS:
· Michael Conte MD, UCSF
· Scott Berceli MD, PhD, University of Florida
Dr. Conte and Dr. Bercelli did previous CRM work that provided key insights in terms of the inflammatory response. In this study blood samples will be collected more frequently and at earlier time points after surgery, along with high-resolution ultrasound imaging. 60 patients undergoing leg bypass surgery will be enrolled.
COLLABORATIVE RESEARCH LABS:· Adam Oskowitz, MD, PhD, UCSF
· Robert Raffai, PhD, UCSF & Department of Veterans Affairs
For both projects, a panel of biomarkers will be measured and correlated with adverse outcomes post-surgery. Circulating exosomes (agents of intercellular communication, e.g. immune response) will also be isolated, studied for their cell signaling properties, and profiled using cutting-edge RNA sequencing technology.
2016 Grant Awards
The 2016 CPCR grants were awarded to teams led by Dr. Karen Ho at Northwestern University and Dr. Larry Kraiss at the University of Utah School of Medicine.
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INVESTIGATORS:
· Karen Ho MD, Northwestern University (PI)· Eugene Chang MD, University of Chicago
· Mary McDermott MD, Northwestern University
· C. Keith Ozaki MD, Northwestern University
Dr. Karen Ho, with collaborators at the University of Chicago and Harvard, is studying the mechanism by which some of the trillions of microbes that live in our gut influence the development of severe atherosclerosis (narrowing of the arteries), including peripheral arterial disease.
The results, titled “Plasma microbiome-modulated indole- and phenyl-derived metabolites associate with advanced atherosclerosis and postoperative outcomes”, was published in the Journal of Vascular Surgery in 2018. Learn more about Dr. Ho’s work in the recent video Predicting PAD: Your Gut Microbiome.
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INVESTIGATORS:
· Larry Kraiss MD, University of Utah (PI)
· Benjamin S. Brooke MD PhD, Shipra Arya MD, Philip P. Goodney MD, Matthew Mel MD, George K. Lee MD, Jason Johanning MD
Dr. Larry Kraiss, with collaborators at Emory, Dartmouth, Stanford, and the University of Nebraska developed a tool to predict a patient’s ability to maintain independent living following surgery. The goal was to enable patients and clinicians to make fully informed decisions about whether or not to have surgery.
Five sites and 403 patients participated in the study. Dr. Kraiss’ work is shown on our YouTube channel video Using Frailty to Predict Surgical Outcomes..
2012 Grant Award
Understanding Peripheral Restenosis: Genomic and Proteomic Determinants of Vascular Intervention (PREDICT-PVI).
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INVESTIGATORS:
· Michael Conte MD, UCSF
· Scott Berceli MD PhD, University of Florida
This project was initiated to gather tissue and data to create a national vascular biobank and improve the success rate of procedures to open blocked arteries in the leg for patients suffering from peripheral artery disease (PAD). The inflammatory response and its resolution are critical to the healing of blood vessels. Excessive scarring of vessels is a common cause of failure of angioplasty, stents, bypass grafts and the arteriovenous fistulas that allow for dialysis.
Recent work has identified critical pathways of the resolution, including those governed by bioactive lipids derived from omega-3 fatty acids (e.g. fish oils). The goal of the first PREDICT-PVI study was to define a set of protein and lipid inflammatory mediators that exhibit a patterned response after surgery, identifying them as candidate biomarkers or treatment targets to improve vascular healing.