Dr. Barshes is an academic vascular surgeon with a focus on the prevention and management of the limb-threatening foot complications associated with diabetes mellitus and/or peripheral arterial disease. His research activities have spanned the spectrum of care for this problem, including: foot ulcer prevention efforts; the microbiology of isolates involved in foot infections; patient selection for revascularization; the timing of soft tissue reconstruction after revascularization; and the cost-effectiveness of prevention and management strategies for peripheral arterial disease and non-healing foot ulcers. The clinical research methodologies used to investigate the research questions for these clinical topics have included randomized controlled trials, large database research, retrospective cohort studies with multivariate analyses and/or propensity scoring, and Markov model simulation with formal cost-utility analyses. Current efforts and plans for future direction include further studies are also focused on further optimizing the value of limb preservation efforts, especially through the improved coordination of multidisciplinary care within the context of a vertically-integrated health care system.