I had a great time talking to Elizabeth Anderson of SmartTRAK about what the real world analysis of diabetic foot ulcer and venous leg ulcer patients revealed, including the astounding similarity of their underlying medical conditions and medications. The prevalence of serious comorbid conditions confirms that chronic non-healing wounds are really a symptom of underlying disease.
We talked about the challenges in wound classification and the arbitrary nature of many wound “diagnoses,” including the overlap of wound types (e.g. DFU patients have venous and pressure ulcers, VLU patients have DFUs since 40% of them have diabetes, etc.). Furthermore, the most prevalent wound types nationally are surgical complications and “the wounds with no name,” meaning the chronic ulcers that are not DFUs, VLUs or pressure ulcers. There are almost no clinical trials on “generic” chronic ulcers. These realities contribute to the significant limitations we face in prospective, randomized cont. rolled trials and thus the role of real-world evidence in clinical research.
There’s a lot more in the interview such as the gaps in care (e.g., failure to provide compression bandaging), the barriers to providing optimal care, the potential impact of Local coverage determinations (LCDs) and other issues in payment policy.
The recording is available only to SmartTRAK subscribers, but the transcript is available on LinkedIn.
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
The opinions, comments, and content expressed or implied in my statements are solely my own and do not necessarily reflect the position or views of Intellicure or any of the boards on which I serve.
