1. Development of an electronic personal assessment questionnaire to capture the impact of living with a vascular condition: ePAQ-VAS
Patrick Phillips, Elizabeth Lumley, Ahmed Aber, Rosie Duncan, Stephen Radley*, Georgina Jones, Jonathan Michaels.
Background - Vascular conditions, such as abdominal aortic aneurysm (AAA), peripheral arterial disease (PAD), carotid arterial disease (CAD) and venous insufficiency (VI), are predominantly chronic in nature, with treatment focused on risk and symptom management. Accurate assessment of clinical symptoms and impact on quality of life (QoL) is important to inform the care and treatment of individuals, as well as the design, development and commissioning of services for populations.
Aim – To develop an electronic personal assessment questionnaire (ePAQ-VAS) for use with vascular patients. This electronic PROM is intended to contribute to improved communication and joint decision making in routine clinical practice. It can also be used to collect routine data that will be useful in research and commissioning contexts.
Methods
Findings from systematic reviews and primary qualitative research were synthesised and relevant dimensions/ domains were identified. These formed the framework for early iterations of a paper-based ePAQ-VAS and ensured content validity.
Some domains were found to be common across all the vascular conditions, for instance pain and anxiety were reported by participants from all categories, whereas concerns about non-healing wounds were specific to PAD and VI patients.
The instrument was developed with a generic dimension, relevant to all vascular patients, as well as 3 condition-specific dimensions relating to AAA, CAD and Lower limb.
Individual items were developed based on the the primary and secondary research findings through an iterative process involving clinicians, academics and software engineers.
A prototype electronic ePAQ-VAS was produced with around 150 individual items; though using screening items the number of items answered by any single patient is reduced.
Feedback on the prototype ePAQ-VAS is being gathered from clinicians as part of a consensus exercise assessing the relevance of included items from a clinical viewpoint.
Opinion regarding the content and format of the report that will be accessed by clinical staff is also being sought.
1:1 interviews with vascular patients have been conducted and data are being analysed regarding the acceptability and usability of ePAQ-VAS in relation to clarity, relevance and emotional response of currently included items.
The next stage of the research involves revising ePAQ-VAS before recruiting a further 1000 vascular patients to trial it.
Recruitment and the subsequent completion of ePAQ-VAS is intended to replicate practice situations as closely as possible
Item reduction, scale generation and evaluation of psychometric properties are planned to be completed by May 2018.
Findings: The evidence synthesis and semi-structured interviews demonstrated a significant impact on QoL across all vascular conditions. However, the specific QoL issues faced and symptoms experienced varied between individuals and across vascular populations. The current version of ePAQ-VAS is provisional, collecting data on symptoms and QoL issues across four overarching dimensions i) generic issues (applicable to all patients with a vascular condition), ii) CAD, iii) AAA, and iv) combined arterial and vascular lower limb problems (with putative domains including pain, sensation, weakness, mobility, central nervous system, vision, activities of daily living, QoL, anxiety and ulceration). Further testing and evaluation will be carried out to explore the structure and psychometric properties of the instrument as well as the acceptability and feasibility of  the instrument to collect routine patient outcome data and as a clinical assessment tool.
scharr.dept.shef.ac.uk/vascular-research/
This presentation presents independent research funded by the National Institute for Health Research (NIHR) under the Programme Grants for Applied Research programme (RPPG ). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
@patphillips1867
@scharrheds
*Stephen Radley is a director and shareholder in ePAQ Systems Ltd, an NHS spin-out technology company, largely owned by Sheffield Teaching Hospitals NHS Foundation Trust