Caitlin W. Hicks, M.D., M.S. Assistant Professor of Surgery Recipient of the Department of Surgery Rothman Early Career Development Award for Surgical Research Johns Hopkins Medicine

Use of AV Grafts Drops in Dialysis Patients, But Still Room For Improvement

MedicalResearch.com Interview with:

Caitlin W. Hicks, M.D., M.S. Assistant Professor of Surgery Recipient of the Department of Surgery Rothman Early Career Development Award for Surgical Research Johns Hopkins Medicine

Dr. Hicks

Caitlin W. Hicks, M.D., M.S.
Assistant Professor of Surgery
Recipient of the Department of Surgery
Rothman Early Career Development Award for Surgical Research
Johns Hopkins Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Arteriovenous fistula are associated with better long-term patency, lower rates of infection, and lower long-term costs compared to arteriovenous graft. As a result, the Fistula First Catheter Last Guidelines recommend placement of an arteriovenous fistula over an AVG whenever possible.

We looked at individual physician utilization of AVF vs AVG for first-time AV access in Medicare beneficiaries. We found that the median physician utilization rate for AVG was only 18%, but that 21% of physicians use AVG in more than 34% of cases, which is above currently recommended  practice guidelines. 

MedicalResearch.com: What should readers take away from your report?

Response: Overall, the utilization of arteriovenous graft has decreased substantially since earlier reports on this topic. However, there is still significant room for improvement. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: We envision an individualized feedback intervention whereby outlier physicians would receive notification of their outlier status and educational material on why arteriovenous fistula are preferred for access over AVG. We would like to evaluate whether such an intervention can reduce arteriovenous graft utilization rates even further. Similar interventions have been shown to effectively improve performance in a non-punitive manner in other fields. 

No disclosures 

Citation:

Hicks CW, Wang P, Kernodle A, Lum YW, Black JH, Makary MA. Assessment of Use of Arteriovenous Graft vs Arteriovenous Fistula for First-time Permanent Hemodialysis Access. JAMA Surg. Published online June 12, 2019. doi:10.1001/jamasurg.2019.1736 

[wysija_form id=”3″]

Jun 13, 2019 @ 6:34 pm 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

No Comments

Post A Comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.