Mixed methods study to develop the content validity and the conceptual framework of the electronic patient-reported outcome measure for vascular conditions.

Published on Aug 11, 2020in BMJ Open2.496
· DOI :10.1136/BMJOPEN-2019-034154
Ahmed Aber10
Estimated H-index: 10
(University of Sheffield),
Patrick C. Phillips66
Estimated H-index: 66
(University of Sheffield)
+ 5 AuthorsJonathan Michaels33
Estimated H-index: 33
(University of Sheffield)
Sources
Abstract
OBJECTIVE: The aim of this paper is to describe the stages undertaken to generate the items and conceptual framework of a new electronic personal assessment questionnaire for vascular conditions. DESIGN: A mixed methods study: First a survey of vascular clinicians was completed to identify the most common conditions treated in vascular clinics and wards. Quantitative systematic reviews were done to identify validated patient-reported outcome measures (PROMs) for direct inclsuion in the new instrument. However, due to scarcity of validated PROMs, the items of the new instrument were mainly based on a large qualitative study of patients and systematic reviews of the qualitative evidence . This was followed by a quantitative clinicians' consensus study and, finally, a qualitative face validity study with patients. PARTICIPANTS: Vascular patients participated in the primary qualitative study and the face validity study. In the qualitative study, 55 patients were interviewed, and for the face validity, 19 patients gave feedback. Twelve clinicians completed the survey and 13 completed two cycles of the clinicians' consensus study. RESULTS: The items and scales in the electronic personal assessment questionnaire for vascular conditions (ePAQ-VAS) were generated based on the results of five systematic reviews evaluating existing PROMs for possible inclusion in ePAQ-VAS, five systematic reviews of qualitative evidence, a primary qualitative study involving 55 patients and clinicians' input. One hundred and sixty-eight items were initially generated, of which 59 were eliminated by the expert panel due to repetition. The instrument was divided into one generic and three disease-specific sections (abdominal aortic aneurysm, carotid artery disease and lower limb vascular conditions). In each section, items were grouped together into putative scales. Fifty-five items were grouped across eight scales; the remaining items were kept as individual items, because of relevance to service users. CONCLUSIONS: This multidimensional electronic questionnaire covers the most common vascular conditions. This is particularly important for patients presenting with mixed symptoms or multiple conditions. This tool captures symptomatology, health related quality of life (HRQoL) and other clinically relevant data, such as experience with services and comorbidities.
References17
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#1Ahmed Aber (University of Sheffield)H-Index: 10
#2Aoife Howard (University of Sheffield)H-Index: 3
Last. Jonathan Michaels (University of Sheffield)H-Index: 33
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Objectives The aim of this study was to identify themes that determine health-related quality of life (HRQoL) in patients with carotid artery stenosis and identify the patient-reported outcome measures (PROMs) that best cover the identified themes.
8 CitationsSource
#1Elizabeth Lumley (University of Sheffield)H-Index: 4
#2Patrick C. Phillips (University of Sheffield)H-Index: 66
Last. Jonathan Michaels (University of Sheffield)H-Index: 33
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Aim To identify the symptoms and quality of life impacts that are important from the perspective of patients with varicose veins and to compare identified themes to items in varicose vein patient‐reported outcome measures (PROMs). Background Varicose veins are common worldwide and are considered a chronic condition with implications for quality of life. Treatment is predominantly conservative; therefore, understanding patients’ experiences of living with varicose veins is important to inform the...
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#1Ahmed Aber (University of Sheffield)H-Index: 10
#2Elizabeth Lumley (University of Sheffield)H-Index: 4
Last. Jonathan Michaels (University of Sheffield)H-Index: 33
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Abstract Objectives The aim of this study was to identify domains that determine quality of life in patients with peripheral arterial disease and find the patient-reported outcome measures that can examine the identified themes. Methods A systematic review of all the main six databases was undertaken to identify primary qualitative studies reporting on the health and/or quality of life of patients with peripheral arterial disease. The quality of studies was assessed using the Critical Appraisal ...
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#1Munira Essat (University of Sheffield)H-Index: 12
#2Ahmed Aber (University of Sheffield)H-Index: 10
Last. Jonathan Michaels (University of Sheffield)H-Index: 33
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Objective: Patient-reported outcome measures (PROMs) provide a way to measure the impact of a disease and its associated treatments on the quality of life from the patients’ perspective. The aim of this review was to identify PROMs that have been developed and/or validated in patients with carotid artery stenosis (CAS) undergoing revascularisation and to assess their psychometric properties and examine suitability for research and clinical use. Methods: Eight electronic databases including MEDLI...
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#1Patrick C. Phillips (University of Sheffield)H-Index: 66
#2Elizabeth Lumley (University of Sheffield)H-Index: 4
Last. Jonathan Michaels (University of Sheffield)H-Index: 33
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Aim To systematically identify, evaluate and synthesise qualitative research that examined the symptoms and health related quality of life themes that are important from the perspective of patients with venous leg ulceration. Background Venous leg ulceration is a common chronic condition; the symptoms and associated treatments have a negative effect on health-related quality of life. Qualitative research methods can provide insight into the personal experiences of patients with venous leg ulcera...
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#1Edith Poku (University of Sheffield)H-Index: 12
#2Ahmed Aber (University of Sheffield)H-Index: 10
Last. Jonathan Michaels (University of Sheffield)H-Index: 33
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Background:A variety of instruments have been used to assess outcomes for patients with venous legulcers. This study sought to identify, evaluate and recommend the most appropriate patient-reportedoutcome measures (PROMs) for English-speaking patients with venous leg ulcers.Methods:This systematic review used a two-stage search approach. Electronic searches of majordatabases including MEDLINE were completed in October 2015, and then updated in July 2016.Additional studies were identified from ci...
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#1Ahmed Aber (University of Sheffield)H-Index: 10
#2Edith Poku (University of Sheffield)H-Index: 12
Last. Jonathan Michaels (University of Sheffield)H-Index: 33
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Background Varicose veins can affect quality of life. Patient-reported outcome measures (PROMs) provide a direct report from the patient about the impact of the disease without interpretation from clinicians or anyone else. The aim of this study was to examine the quality of the psychometric evidence for PROMs used in patients with varicose veins. Methods A systematic review was undertaken to identify studies that reported the psychometric properties of generic and disease-specific PROMs in pati...
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#1Rosie Duncan (University of Sheffield)H-Index: 7
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Background The aim was to identify and evaluate existing patient-reported outcome measures (PROMs) for use in patients with an abdominal aortic aneurysm (AAA) to inform the selection for use in surgical practice. Methods Two reviews were conducted: a systematic review to identify valid, reliable and acceptable PROMs for patients with an AAA, and a qualitative evidence synthesis to assess the relevance to patients of the identified PROM items. PROM studies were evaluated for their psychometric pr...
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#1Edith Poku (University of Sheffield)H-Index: 12
#2Rosie Duncan (University of Sheffield)H-Index: 7
Last. Jonathan Michaels (University of Sheffield)H-Index: 33
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Background Peripheral arterial disease (PAD) is generally associated with considerable morbidity and reduced quality of life. Patient-reported outcome measures (PROMs) provide important information about the burden of disease and impact of treatment in affected patients.
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#1G. PeachH-Index: 5
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#### Summary points Peripheral arterial disease (PAD) is an atherosclerotic process that causes stenosis and occlusion of non-cerebral and non-coronary arteries. It has an estimated worldwide prevalence of almost 10%, rising to 15-20% in people over 70 years of age,1 2 and it affects around 27 million people in Europe and North America alone.3 Critical limb ischaemia—the most severe manifestation of the disease—can lead to limb loss or even death if not treated promptly. Each year, 500-1000 new ...
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Like many areas of medicine, vascular surgery has been transformed by the COVID-19 pandemic. Public health precautions to minimize disease transmission have led to reduced attendance at hospitals and clinics in elective and emergency settings, fewer face-to-face and hands-on clinical interactions, and increased reliance on telemedicine, virtual attendance, investigations, and digital therapeutics. However, a silver lining to the COVID-19 pandemic may be the mainstream acceptance and acceleration...
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Abstract Background Vascular surgery is considered a risk factor for the development of postoperative delirium (POD). In this systematic review we provide a report on the incidence and risk-factors of POD after vascular surgery. Methods A systematic literature search was conducted using Pubmed with the MeSH terms and key words “delirium” or “confusion”, “vascular surgery procedures” and “risk factors or “risk assessment”. Studies were selected for review after meeting the following inclusion cri...
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Abstract: Atherosclerotic carotid artery disease is a significant cause of stroke in the US and globally. Its prevalence increase with age and its more prevalent in men, Caucasians and Native Americans. However, the outcomes related to carotid disease are worse in women and Black patients. Research suggests the disparities exist due to a multitude of factors including disease pathophysiology, access to care, provider bias and socioeconomic status. The prevalence of carotid stenosis in general po...
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#1Ahmed Aber (University of Sheffield)H-Index: 10
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BACKGROUND: This paper describes the development and validation of an electronic personal assessment questionnaire for vascular conditions (ePAQ-VAS) that captures the symptomatology, quality of life and clinically relevant data of patients presenting to vascular services. METHODS: A two-stage survey was conducted in patients attending a tertiary vascular department. Patients completed the ePAQ-VAS remotely online, or on site using an electronic tablet. In the first stage of the survey, the resp...
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