Limitations
The lack of complete prospective data for all patients seen in the clinic, in particular incomplete data in relation to healing rates within the cohort, limits understanding of the precise mechanism by which the reduction in admissions has occurred.
The data source for this study, HIPE, is collected prospectively, by chart review, by trained clinical coders at the time of discharge. The coders review patient notes, radiology and lab data, as well as discharge summaries, to code each admission. The coders receive clinical training, but the focus of the coding is intended towards finance rather than research. There is the potential for some patients to be incorrectly coded, so HIPE data can be limited in its accuracy for each individual case. However, over the course of hundreds of admissions, as in the NSQIP (National Surgical Quality Improvement Program) database run by the American College of Surgeons or HES (Hospital Episode Statistics) database, in the NHS, these inaccuracies are expected to be evenly distributed.
Perforators were treated with foam sclerotherapy and were not singled out as a separate modality in data collection.
Conflict of Interest
The authors declare no conflict of interest.
Funding
This research did not receive any specific funding from agencies in the public, commercial, or not-for-profit sectors.
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