Figure 1 depicts the key questions (KQs) within the context of the PICO (population, interventions, comparators, and outcomes) described elsewhere in this document. In general, the figure shows that the population of interest is adults with peripheral artery disease, including asymptomatic patients and patients with intermittent claudication or critical limb ischemia. Key Question 1 considers the comparative effectiveness of aspirin and other antiplatelet agents in reducing the risk of adverse cardiovascular events (e.g., myocardial infarction, stroke, cardiovascular death) and whether the effectiveness of treatments varies according to the patient's symptomatic status or by subgroup (age, sex, race, comorbidities). For patients with intermittent claudication due to peripheral artery disease, Key Question 2 considers the comparative effectiveness of exercise training, medications (cilostazol, pentoxifylline), endovascular intervention (percutaneous transluminal angioplasty, atherectomy, or stents), and/or surgical revascularization (endarterectomy, bypass surgery) on improving functional capacity and quality of life as well as whether the effectiveness of treatments varies by subgroup (age, sex, race, comorbidities, anatomic location of disease). For patients with critical limb ischemia, Key Question 3 considers the comparative effectiveness of endovascular intervention and surgical revascularization for outcomes including vessel patency, revascularization, wound healing, analog pain scale, cardiovascular events, amputation, and mortality (including amputationā€free survival) and whether the effectiveness of treatments varies by subgroup (age, sex, race, comorbidities, anatomic location of disease). All three Key Questions consider the significant safety concerns associated with each treatment strategy (e.g., adverse drug reactions, contrast nephropathy, radiation, infection, bleeding, exercise-related harms, and periprocedural complications causing acute limb ischemia) as well as whether the risks vary by subgroup (age, sex, race, comorbidities, anatomic location of disease).

Figure 1Analytic framework

Abbreviations: KQ=Key Question; PAD=peripheral artery disease.

From: Introduction

Cover of Treatment Strategies for Patients With Peripheral Artery Disease
Treatment Strategies for Patients With Peripheral Artery Disease [Internet].
Comparative Effectiveness Reviews, No. 118.
Jones WS, Schmit KM, Vemulapalli S, et al.

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