NEWS FROM THE FIELD

Dr. Krista Mahoney, a Postdoctoral researcher with the Translational and Personalized Medicine Initiative (TPMI), is the principal investigator of a study examining the test utilization patterns of the provincial vascular clinic in Newfoundland and Labrador. The main objective of this study is to examine the utilization patterns of peripheral artery testing and to determine predictors of critical disease.

The only tertiary referral clinic for the province, located at St. Clare’s Mercy Hospital in St. John’s, has teamed up with the TPMI to analyze data on patient demographics, clinical characteristics, and test indications. This project is currently at the end of the data analysis phase and intervention strategies are now being developed.

One important finding was that approximately half of the patients that are getting the more time-consuming, detailed tests, have normal test results. This finding has led to a movement towards completing a quick screening test first, to determine if the more detailed tests are necessary and reduce the number of more expensive tests overall.

We have also found that most patients who have a normal test result do not have a strong reason to receive the test. This means that the number of low risk patients referred for peripheral artery testing is too high. Therefore, if we focus on reducing the number of tests in these patients, we will improve access for high risk patients throughout the province.
 
Newfoundland has the highest provincial rates of multiple indicators of vascular disease, including diabetes, secondary stroke, obesity, and smoking. The only tertiary referral centre in the province needs to optimize access for high risk patients. Multiple intervention strategies are currently in development, including improvements to referral processes and providing feedback to physicians.