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Patient Reported Outcome Measures in Interventional Cardiology: Listen to the Patient

Kemp, I (2021) Patient Reported Outcome Measures in Interventional Cardiology: Listen to the Patient. Doctoral thesis, Liverpool John Moores University.

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Abstract

Patient Reported Outcome Measures (PROMs) are instruments that seek patients’ views on symptoms, functional status and health related quality of life. My thesis analyses data from the Stent or Surgery Trial. A cohort of 988 patients completed several PROMs before, and at two time points after their revascularisation procedure, and this data forms the basis of my thesis. I found discordance between patients’ and their physicians with physicians slightly overstating angina burden prior to revascularisation and under reporting at twelve months post procedure by comparison to patients. I compared the generic EuroQol EQ-5D and disease specific Seattle Angina Questionnaire (SAQ) to assess the degree of agreement. I found the EQ-5D visual analogue scale (VAS) had poor correlation with any of the five domains of the SAQ. However, the VAS relates to how a patient feels at the time of completion and the SAQ refers to the previous four weeks. I then compared the full 19 question SAQ with a short 7 question version (SAQ-7). A single summary score was calculated for both instruments. Each timepoint showed a strong positive linear correlation above 0.9. The implication of this finding is there may be greater take-up for a PROM with fewer questions and that a single summary score is easier to understand. Finally, I examined some strengths and weaknesses of questionnaires. Advantages include expense, practicality, speed and anonymity. Disadvantages included user fatigue, dishonesty and bias in the way the questionnaire is designed. PROMs in the UK tend to be used to compare performance between individual operators or Trusts. In other countries such as Sweden they are used to calibrate individual patients’ treatment plans.

Item Type: Thesis (Doctoral)
Uncontrolled Keywords: PROM; Discordance; Cardiology; Patient Reported; SAQ; EQ-5D
Subjects: Q Science > QA Mathematics > QA76 Computer software
R Medicine > R Medicine (General)
Divisions: Computer Science & Mathematics
Date Deposited: 12 May 2021 08:24
Last Modified: 19 Dec 2022 15:57
DOI or ID number: 10.24377/LJMU.t.00014982
Supervisors: Lisboa, P
URI: https://researchonline.ljmu.ac.uk/id/eprint/14982
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