We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Development of a percutaneous coronary intervention patient level composite measure for a clinical quality registry.
- Authors
Ayton, Darshini; Soh, Sze-Ee; Morello, Renata; Ahern, Susannah; Earnest, Arul; Brennan, Angela; Lefkovits, Jeffrey; Evans, Susan; Reid, Christopher; Ruseckaite, Rasa; McNeil, John
- Abstract
<bold>Background: </bold>Composite measures combine data to provide a comprehensive view of patient outcomes. Despite composite measures being a valuable tool to assess post-intervention outcomes, the patient perspective is often missing. The purpose of this study was to develop a composite measure for an established cardiac outcome registry, by combining clinical outcomes following percutaneous coronary interventions (PCI) with a patient-reported outcome measure (PROM) developed specifically for this population (MC-PROM).<bold>Methods: </bold>Two studies were undertaken. Study 1: Patients who had undergone a PCI at one of the three participating registry hospital sites completed the 5-item MC-PROM. Clinical outcome data for the patients (e.g. death, myocardial infarction, repeat vascularisation, new bleeding event) were collected 30 days post-intervention as part of routine data collection for the cardiac registry. Exploratory factor analysis of clinical outcomes and MC-PROM data was conducted to determine the minimum number of constructs to be included in a composite measure. Study 2: Clinical experts participated in a Delphi technique, consisting of three rounds of online surveys, to determine the clinical outcomes to be included and the weighting of the clinical outcomes and MC-PROM score for the composite measure.<bold>Results: </bold>Study 1: Routine clinical outcomes and the MC-PROM data were collected from 266 patients 30 days post PCI. The MC-PROM score was not significantly correlated with any clinical outcomes. Study 2: There was a relatively consistent approach to the weighting of the clinical outcomes and MC-PROM items by the expert panel (n = 18) across the three surveys with the exception of the clinical outcome of 'deceased at 30 days'. The final composite measure included five clinical outcomes within 30 days weighted at 90% (new heart failure, new myocardial infarction, new stent thrombosis, major bleeding event, new stroke, unplanned cardiac rehospitalisation) and the MC-PROM score (comprising 10% of the total weighting).<bold>Conclusions: </bold>A single patient level composite score, which incorporates weighted clinical outcomes and a PROM was developed. This composite score provides a more comprehensive reported measure of individual patient wellbeing at 30 days post their PCI-procedure, and may assist clinicians to further assess and address patient level factors that potentially impact on clinical recovery.
- Subjects
PERCUTANEOUS coronary intervention; EXPLORATORY factor analysis; CARDIAC pacing; DELPHI method; MYOCARDIAL infarction; MEDICAL quality control; MEDICAL care; ACQUISITION of data; CARDIOVASCULAR system; TREATMENT effectiveness; RESEARCH funding
- Publication
BMC Health Services Research, 2020, Vol 20, Issue 1, p1
- ISSN
1472-6963
- Publication type
journal article
- DOI
10.1186/s12913-019-4814-6