1. NICOR
A NICE Commissioned Pilot of Patient Reported Outcome Measures (PROMs) for Ablation of Cardiac Arrhythmias Withers KL 1, Patrick H 2, Cunningham D 3, Carter B 4, O’Callaghan P 5, Murray S 6, Griffith M 7.
Methods:
After developing the tools to meet Welsh language requirements and making Caldicott applications, a total of 791 patients were sent questionnaires:
University Hospital Birmingham (397)
University Hospital Wales, Cardiff (200) and
Freeman Hospital NHS Trust (194)
Data Storage:
The Central Cardiac Audit Database (CCAD) was modified to allow PRO data to be added to existing clinical data without affecting anonymity.
Results:
Responses were received from 584 patients (74%). Preliminary analysis indicates that a significant number of patients have observed an improvement in their quality of life since the procedure.
Background:
Patient Reported Outcome Measures (PROMs) assess patients’ health or health related quality of life. Questionnaires are used to assess a patient’s experience of pain, mobility and impact on daily routine before and after a clinical procedure.
Since April 2009 PROMs have been collected by providers of NHS funded care for four clinical procedures; hip replacements; knee replacement; varicose vein surgery and hernias.
In November 2010, Cedar was commissioned by the National Institute for Health and Clinical Excellence (NICE) to pilot the use of two new disease specific questionnaires for the assessment of patient reported outcomes from cardiac ablative procedures. These were based on work carried out in the United States by Wood et al (2009) and further developed by the University Hospital, Birmingham.
Aim
To explore the feasibility of using questionnaires (including the two newly developed disease specific tools and a generic tool such as EQ5D) to assess outcomes from cardiac ablation at three specialist centres in the UK.
Cardiac arrhythmias are abnormal heart rhythms which can cause symptoms including chest pain, headache and fatigue. Some arrhythmias are caused by abnormal electrical activity within the heart. During ablation, a catheter is inserted into a blood vessel in the groin and guided to the heart. Here radiofrequency energy is used to destroy the small area of heart tissue causing the abnormality.
Next steps:
In conjunction with academic, clinical and colleagues at NICE, Cedar aim to progress this project to a stage where it is suitable for use as a National PROM. This process will require:
Further statistical analysis
Grant applications
Ethics applications
Validation of the questionnaires
References: Wood KA, Stewart AL Drew BJ, Scheinman MM, and Froëlicher ES. Development and initial psychometric evaluation of the patient perspective of arrhythmia questionnaire. Research in Nursing & Health 2009;32:
1 CEDAR, 2 NICE, 3 NICOR, 4 Cardiff University, 5 Cardiff and Vale University Health Board, 6 Freeman Hospital, 7 University Hospital Birmingham