Shipra Arya
Stanford University, CA·Medicine & Clinical Research
More medical care is not always better care. Overtreatment raises costs and can harm patients.
- Fields
Medicine & Clinical Research
Public Health & Epidemiology
Social Science
- Topics
vascular surgery
abdominal aortic aneurysm
peripheral artery disease
- Grants
- 1 known grant, through May 2031
What they work on
- Test whether greater market competition among surgeons is associated with higher rates of guideline-discordant small abdominal aortic aneurysm repair and tibial interventions for claudication, using linked Vascular Quality Initiative–Medicare and Veterans Health Administration data.
- Determine whether early endovascular intervention improves re-intervention-free survival for abdominal aortic aneurysm and amputation-free survival for peripheral artery disease in older adults.
- Examine whether market competition worsens outcomes of aneurysm and peripheral artery disease care for two high-risk groups: adults over 75 and frail adults.
More about the research
In vascular surgery, two kinds of possible overtreatment have drawn national attention. The first is repair of small abdominal aortic aneurysms (AAA), bulges in the body's main artery. Guidelines recommend monitoring small aneurysms (4.0–5.4 cm), because trials show no benefit from surgery. The second involves claudication, leg pain with walking that is an early sign of peripheral artery disease (PAD). Here, procedures on the tibial (lower-leg) arteries are not considered appropriate, yet are increasingly performed and may lead to amputations. The project proposes to test one explanation: that competition among surgeons, combined with fee-for-service payment, pushes surgery earlier than recommended.
Why it matters
Older adults with aortic aneurysms or leg artery disease may receive surgery earlier than guidelines advise, risking re-operations and amputations. Learning whether market competition drives this could help payers and health systems design provider networks and reimbursement that protect elderly and frail patients from unnecessary procedures.
Known grants
From NIH and NSF research grants. Labs often have other funding we can't see.
Closest labs
Vinay Kini
Weill Medical College of Cornell University, NY·Medicine & Clinical Research
Test whether commonly used claims-based measures of low-value care for patients with coronary artery disease are accurate by comparing them against the gold standard of medical chart review.
Katharine McGinigle
University of North Carolina at Chapel Hill, NC·Medicine & Clinical Research
Identify patient traits linked to different disease courses and treatment patterns after the first blood-flow-restoring procedure, using machine learning on data from the 1,830-patient BEST-CLI trial.
David Chan
University of California-Berkeley, CA·Social Science
Validate data-driven measures of pneumonia diagnoses and outcomes among 5.5 million chest X-ray visits in Veterans Health Administration emergency departments. Use quasi-random assignment of patients to radiologists to infer differences in false-positive and false-negative rates.
The school
Stanford University: 87 labs on PI Pages, $1.6B a year on research, 739 research doctorates a year.
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