Aber Ahmed, Phillips Patrick, Lumley Elizabeth, Radley Stephen, Thomas Steven M, Nawaz Shah, Jones Georgina, Michaels Jonathan
ScHARR, The University of Sheffield, Sheffield, UK
ScHARR, The University of Sheffield, Sheffield, UK.
BMJ Open. 2020 Aug 11;10(8):e034154. doi: 10.1136/bmjopen-2019-034154.
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.
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.
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.
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.
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.
本文旨在描述为生成一份针对血管疾病的新型电子个人评估问卷的条目及概念框架所采取的步骤。
一项混合方法研究：首先完成了一项针对血管临床医生的调查，以确定血管诊所和病房中治疗的最常见疾病。进行了定量系统评价，以确定可直接纳入新工具的经过验证的患者报告结局指标（PROMs）。然而，由于经过验证的PROMs数量稀少，新工具的条目主要基于对患者的一项大型定性研究以及对定性证据的系统评价。随后进行了定量的临床医生共识研究，最后进行了针对患者的定性表面效度研究。
血管疾病患者参与了初步定性研究和表面效度研究。在定性研究中，采访了55名患者，在表面效度研究中，19名患者提供了反馈。12名临床医生完成了调查，13名临床医生完成了两轮临床医生共识研究。
血管疾病电子个人评估问卷（ePAQ-VAS）中的条目和量表是基于五项系统评价的结果生成的，这五项系统评价评估了现有可能纳入ePAQ-VAS的PROMs，五项定性证据的系统评价，一项涉及55名患者的初步定性研究以及临床医生的意见。最初生成了168个条目，其中59个因重复被专家小组剔除。该工具分为一个通用部分和三个疾病特定部分（腹主动脉瘤、颈动脉疾病和下肢血管疾病）。在每个部分中，条目被分组为假定的量表。55个条目被归为八个量表；其余条目因其与服务使用者的相关性而保留为单个条目。
这份多维电子问卷涵盖了最常见的血管疾病。这对于出现混合症状或多种疾病的患者尤为重要。该工具可获取症状、健康相关生活质量（HRQoL）以及其他临床相关数据，如服务体验和合并症。
