{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:58:33Z","timestamp":1787068713901,"version":"build-2736575974"},"reference-count":41,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T00:00:00Z","timestamp":1576627200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Advances in Wound Care"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To develop a venous leg ulcer (VLU) risk stratification system for use in research and clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach:<\/jats:title>\n                    <jats:p>\n                      U.S. Wound Registry data were examined retrospectively and assigned an outcome. Bivariate analysis identified significant variables (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05) that were used to create a multivariable logistic regression model. Ulcers with data for wound area at the first visit before debridement were included in regression analysis, which was based on a 90% development sample. The model was validated on a hold-out 10% data sample.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The original dataset included 26,713 VLUs, of which 11,773 ulcers were eligible for preliminary analysis and 10,942 ulcers were eligible for regression analysis. The 90% development model included 9,898 ulcers, of which 7,498 healed (75.8%). The 10% validation sample included 1,044 ulcers, of which 809 healed (77.5%). The following variables significantly predicted healing: number of concurrent wounds of any etiology, wound size, wound age (in days), evidence of bioburden\/infection, being nonambulatory, and hospitalization for any reason.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Innovation:<\/jats:title>\n                    <jats:p>The VLU Wound Healing Index (WHI) is a comprehensive, validated risk stratification model for predicting VLU healing that incorporates patient- and wound-specific variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The WHI can identify which VLUs most likely require adjunctive therapies to heal, prioritize referral to venous experts, risk-stratify ulcers to create more generalizable clinical trials and understand the impact of clinical interventions. The Centers for Medicare and Medicaid Services accepts this method for reporting VLU outcome under the Quality Payment Program.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/wound.2019.1038","type":"journal-article","created":{"date-parts":[[2019,8,27]],"date-time":"2019-08-27T11:44:45Z","timestamp":1566906285000},"page":"68-77","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["The Wound Healing Index for Predicting Venous Leg Ulcer Outcome"],"prefix":"10.1177","volume":"9","author":[{"given":"Caroline E.","family":"Fife","sequence":"first","affiliation":[{"name":"U.S. Wound Registry, The Woodlands, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan D.","family":"Horn","sequence":"additional","affiliation":[{"name":"International Severity Information Systems, Inc., Salt Lake City, Utah."},{"name":"School of Medicine, University of Utah, Salt Lake City, Utah."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,12,18]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.3111\/13696998.2014.903258"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000305486.06358.e0"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2017.0743"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12523"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12538"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.10.1209"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2018.0830"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.24.1.180"},{"key":"e_1_3_5_10_2","unstructured":"U.S. Department of Health and Human Services Food and Drug Administration Center for Devices and Radiological Health Center for Biologics Evaluation and Research. Use of Real-World Evidence to Support Regulatory Decision-Making for Medical Devices: Draft Guidance for Industry and Food and Drug Administration Staff. 2016. www.fda.gov\/downloads\/MedicalDevices\/DeviceRegulationandGuidance\/GuidanceDocuments\/UCM513027.pdf?source5govdelivery&utm_medium5email&utm_source5govdelivery (last accessed February12 2019)."},{"key":"e_1_3_5_11_2","volume-title":"Key capabilities of an Electronic Health Record system (Electric Health Record Functional Model: Letter Report)","author":"Institute of Medicine","year":"2003","unstructured":"Institute of Medicine. Key capabilities of an Electronic Health Record system (Electric Health Record Functional Model: Letter Report). Washington, DC: Institute of Medicine National Academies Press, 2003. www.nap.edu\/catalog.php?record_id=10781. (last accessed November6, 2018)."},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12107"},{"key":"e_1_3_5_13_2","volume-title":"Cooperative agreement funding announcement: improving infrastructure for conducting patient-centered outcomes research. The National Patient-Centered Clinical Research Network","author":"Patient-Centered Outcomes Research Institute (PCORI)","unstructured":"Patient-Centered Outcomes Research Institute (PCORI). Cooperative agreement funding announcement: improving infrastructure for conducting patient-centered outcomes research. The National Patient-Centered Clinical Research Network. Clinical Data Research Networks (CDRN)\u2014Phase One. April 23, 2013. http:\/\/pcori.org\/assets\/PCORI-CDRN-Funding-Announcement-042313.pdf. (last accessed November6, 2018)."},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.11.069"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.11.007"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2006.15.7.26936"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1067-1927.2004.012207.x"},{"key":"e_1_3_5_18_2","first-page":"28","article-title":"Improving accuracy of wound measurement in clinical practice","volume":"49","author":"Flanagan M","year":"2003","unstructured":"Flanagan M. Improving accuracy of wound measurement in clinical practice. Ostomy Wound Manage, 2003; 49:28\u201340.","journal-title":"Ostomy Wound Manage"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1747.2002.19629.x"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2005.14.1.26723"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2002.11.3.26381"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2007.00328.x"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2017.06.017"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5597"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2004.10.002"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.12.055"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2008.00397.x"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(93)70061-W"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2016.25.11.626"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.1999.8.6.25885"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2001.115379"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2000.106493"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/00129334-200203000-00007"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8019.2006.00096.x"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12859"},{"key":"e_1_3_5_36_2","first-page":"16","article-title":"Predicting the likelihood of delayed venous leg ulcer healing and recurrence: development and reliability testing of risk assessment tools","volume":"63","author":"Parker CN","year":"2017","unstructured":"Parker CN, , Finlayson KJ, , Edwards HE. Predicting the likelihood of delayed venous leg ulcer healing and recurrence: development and reliability testing of risk assessment tools. Ostomy Wound Manage, 2017; 63:16\u201333.","journal-title":"Ostomy Wound Manage"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2010.00627.x"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-5945-9-2"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.1097\/00129334-200604000-00009"},{"key":"e_1_3_5_40_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2009.00464.x"},{"key":"e_1_3_5_41_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10441-010-9112-y"},{"key":"e_1_3_5_42_2","unstructured":"U.S. Wound Registry. Quality Measures Provided by the US Wound & Podiatry Registries. https:\/\/uswoundregistry.com\/quality-measures\/(last accessed May30 2019)."}],"container-title":["Advances in Wound Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/wound.2019.1038","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/wound.2019.1038","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/wound.2019.1038","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T14:14:14Z","timestamp":1773238454000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/wound.2019.1038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,18]]},"references-count":41,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1089\/wound.2019.1038"],"URL":"https:\/\/doi.org\/10.1089\/wound.2019.1038","relation":{},"ISSN":["2162-1918","2162-1934"],"issn-type":[{"value":"2162-1918","type":"print"},{"value":"2162-1934","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,18]]}}}