Psychosocial risk factors continue to be a reason for VAD ineligibility for many patients, but outcomes associated with risk are inconsistent, absent, or involve poorly defined criteria. In the absence of clear evidence linking psychosocial factors to VAD outcomes, standardized and transparent selection protocols are needed to reduce disparities, support informed clinical judgment, and align with national calls for consistent tools and communication across centers. We propose the following actionable recommendations for clinicians, researchers, and the Centers of Medicaid and Medicare (CMS): 1) Establish comprehensive and up-to-date guidance regarding psychosocial factors, 2) Generate high-quality outcomes-based research focused on psychosocial evaluation findings and their impact on health outcomes, and 3) Promote dissemination of the evaluation protocol across centers to share meaningful, evidence-based approaches to eligibility.
Latimer et al. (Sun,) studied this question.