Qual / Quant: Mapping the Portal Hypertension Patient Referral Pathway
Talking to referrers first made sure a 201-physician survey asked the right questions.
A manufacturer wanted to understand how US patients with portal hypertension move through the health system, and where a type of portal hypertension surgery fits in the treatment pathway. The focus was on referrers, the physicians who decide whether a patient is sent for the procedure.
The study ran in two phases.
Phase 1 was 21 double-blinded, 60-minute Zoom interviews with eight transplant hepatologists, three hepatologists and 10 gastroenterologists. The recruit called for a mix of referral volumes:
Low: 11 or fewer surgery referrals a year
Medium: about one a month
High: two or more a month
It also sought a mix of hospital sizes, independent liver and GI clinics, public, private and academic settings, and US regions. Physicians with fewer than three years in practice were screened out.
Besides exploring the pathway, phase 1 physicians reviewed and helped validate the draft questionnaire.
Phase 2 was a 30-minute online survey of 201 referring physicians: 131 gastroenterologists and 70 hepatologists or transplant hepatologists.
Including gastroenterologists with lower liver workloads mattered. Many patients first present outside specialist centers, so their habits shape who reaches an interventional radiologist.
Testing the survey in phase 1 gave the client confidence that the quantitative data reflected real practice. A parallel European study used the same design, allowing comparison across markets.
