Evaluating the Vascular Quality Initiative's role in advancing minority health and health disparities research-A scoping review.

Abstract

Social and structural determinants of health (SDOH) significantly influence the management and outcomes of vascular surgical patients. Large databases, such as the Society for Vascular Surgery-Vascular Quality Initiative (SVS-VQI), are important platforms for conducting health disparities research. Moreover, evaluating the SVS-VQI registry variables is crucial to understanding how well it supports this purpose. This study reviews the extent to which current VQI variables facilitate minority health and health disparities research. A scoping review was conducted from VQI inception to present (2011-2025) according to Arksey's five-stage framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews guidelines. Two reviewers independently screened abstracts and selected full texts, with a third reviewer resolving any disagreements. Studies using SVS-VQI data with a primary focus on health disparities were included. Domains from the National Institute on Minority Health and Health Disparities Research Framework-biological, behavioral, physical, and sociocultural environment, and health care systems-were included, whereas studies that focused on SVS-VQI regions, age, and frailty for primary end points or that used linked databases were excluded. Results were reported narratively due to a lack of comparable statistical data. The search identified 968 unique citations using SVS-VQI data; 67 (6.9%) met all inclusion/exclusion criteria. Studies focused on aortic disease, peripheral artery disease, cerebrovascular disease, hemodialysis, and venous disease, with peripheral artery disease (n = 24) and aortic disease (n = 23) being the most studied. Sex was the most commonly studied variable (n = 27) and was linked to presentation, management, and outcomes across pathologies. Outcomes of surgical management were the most commonly studied primary outcomes (n = 51), followed by perioperative management (n = 26) and presentation/severity (n = 26). Improving our understanding of how SDOH impact presentation, management, and outcomes among vascular surgical patients is important to mitigate health disparities. Large national databases such as SVS-VQI can support health care disparities research in a meaningful way; however, current SDOH-related variables are limited. Expanding these variables could enhance future research and quality improvement efforts.