James J. DiResta, DPM, MPH, CECS Dartmouth Medical School, Dartmouth Medical School, Box 7252, MML Building, Hanover, NH 03755, 9784655147 (home), james.j.diresta.DMS04@alum.dartmouth.org

Peripheral arterial disease (PAD) has long been recognized as a predisposing factor in the development of nonhealing pedal ulcers and lower extremity amputations. More recently, PAD has been identified as a risk marker for coronary heart disease, CVA, diabetes and hypertension and many have begun advocating for the measurement of ankle brachial indices (ABI) in the screening of PAD. An improvement project has been initiated to improve the utilization of ABI screening among podiatric physicians who in their daily work encounter a significant number of patients in this at-risk population and are thus in an opportune position to diagnose and treat. The project began through my field experience proposal at the CECS at Dartmouth Medical School and involved soliciting support from DPMs in the Commonwealth of Massachusetts in cooperation with the Massachusetts Podiatric Medical Society. This initiative was developed after obtaining and analyzing pilot data from ABI screenings in a community hospital setting that revealed a statistically significant rate of abnormal ABI readings and recommended further testing for PAD among many of those screened. Should the outcome among this group of specialists (podiatrists) produce similarly significant data, the anticipated next step is to bring this screening into place even earlier on by advocating for ABI screening along side hypertension screening in the primary care setting. Here this more sensitive diagnostic test utilized in the at-risk population will capture a larger number of individuals with PAD before more significant disease has been established and when less aggressive treatment can be implemented.

Learning Objectives:

At the conclusion of this poster presentation the viewer will be able to 1)recognize the significance of ABI screening in the diagnosis of PAD, 2)apply this improvement project to their own daily work to identify and treat patients with PAD and
• develop similar programs in their practice, clinic or community hospital setting.

Keywords: Screening, Health Care Delivery

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.