Moving the needle by making a measurable impact on understanding disease processes and improving patient care.

The concept of using “big data” in health care research was novel in the 1990s, gained momentum in the early 2000s, and has become mainstream in 2022. In contemporary times, when we are inundated with big data studies, investigators are increasingly challenged to apply the data in an innovative fashion that contributes meaningfully to advancing understanding of disease processes and their treatments. In “Insurance Status is Associated with Urgent Carotid Endarterectomy and Worse Postoperative Outcomes,” 1 Chen P. Lazar A. Ding J. Siracuse J.J. Patel V.I. Morrissey N.J. Insurance status is associated with urgent carotid endarterectomy and worse postoperative outcomes. J Vasc Surg. 2023; 77: 818-826 Abstract Full Text Full Text PDF Scopus (2) Google Scholar Chen et al analyzed Vascular Quality Initiative (VQI) data to determine that “Medicaid and uninsured patients are more likely to require urgent [carotid endarterectomy (CEA)].” As the authors acknowledge, the association between underinsured/uninsured status and increased severity of disease presentation and worse treatment outcomes is well documented in the literature, including the vascular disease-specific literature. 2 Eslami M.H. Zayaruzny M. Fitzgerald G.A. The adverse effects of race, insurance status, and low income on the rate of amputation in patients presenting with lower extremity ischemia. J Vasc Surg. 2007; 45: 55-59 Abstract Full Text Full Text PDF PubMed Scopus (149) Google Scholar , 3 Chen J.S. Corcoran Ruiz K.M. Rivera Perla K.M. Liu Y. Nwaiwu C.A. Moreira C.C. Health disparities attributed to Medicare-Medicaid dual-eligible status in patients with peripheral arterial disease. J Vasc Surg. 2022; 75: 1386-1394.e3 Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar , 4 Hughes K. Mota L. Nunez M. Sehgal N. Ortega G. The effect of income and insurance on the likelihood of major leg amputation. J Vasc Surg. 2019; 70: 580-587 Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar , 5 Seifi A. Bahadori M. Gheibi Z. Kanegi S.L. Mirahmadizadeh A. Hospital outcomes in uninsured patients with disease and disorders of nervous system: a national cohort study during a decade in the United States. Cureus. 2021; 13: e13702 PubMed Google Scholar Insurance status is associated with urgent carotid endarterectomy and worse postoperative outcomesJournal of Vascular SurgeryVol. 77Issue 3PreviewUnderinsured patients can experience worse preoperative medical optimization. We aimed to determine whether insurance status was associated with carotid endarterectomy (CEA) urgency and postoperative outcomes. Full-Text PDF