TY - JOUR
T1 - A Novel Quality of Life Instrument for Patients with an Abdominal Aortic Aneurysm
AU - Suckow, Bjoern D.
AU - Schanzer, Andres S.
AU - Hoel, Andrew W.
AU - Wyers, Mark
AU - Marone, Luke K.
AU - Veeraswamy, Ravi K.
AU - Nolan, Brian W.
N1 - Funding Information:
This work was funded by the following, directed toward the primary investigator, Brian W. Nolan, MD, MS. None of these entities had any involvement in study design; collection, analysis, and interpretation of data; manuscript writing; or the decision to submit the manuscript for publication: NHLBI K23 Career Development Award (1K23HL092160-01A2); American College of Surgeons Career Development Award; SVS Clinical Research Grant; PVSS Academic Award; Hitchcock Foundation Award.
Funding Information:
This work was funded by the following, directed toward the primary investigator, Brian W. Nolan, MD, MS. None of these entities had any involvement in study design; collection, analysis, and interpretation of data; manuscript writing; or the decision to submit the manuscript for publication: NHLBI K23 Career Development Award ( 1K23HL092160-01A2 ); American College of Surgeons Career Development Award; SVS Clinical Research Grant; PVSS Academic Award ; Hitchcock Foundation Award.
Publisher Copyright:
© 2019 European Society for Vascular Surgery
PY - 2019/6
Y1 - 2019/6
N2 - Objective: The surveillance and treatment of abdominal aortic aneurysms (AAAs) may impact patient quality of life (QOL). A novel AAA specific QOL instrument was developed and validated to quantify the impact of AAA surveillance on QOL. Methods: The study was performed in two phases: development (2011–2013) and validation (2013–2014) of a survey instrument. Content was informed by focus groups at three centres (22 patients) and two multidisciplinary physician focus groups (6 vascular surgeons, 7 primary care providers). Cognitive interviews (17 patients) ensured questions were understood as intended. The final survey was mailed to AAA patients at six US institutions. Patients were scored on two AAA specific domains of QOL: emotional impact (EIS) and behavioural change (BCS), range 0–100 with higher scores indicating worse quality of life. Test retest reliability and internal consistency were assessed. Discriminant validity was determined by comparing scores between patients under surveillance vs. those who had undergone AAA repair. Scores were externally validated by correlation with the Short Form (SF)-12. Results: A total of 1,008 (73%) of 1,373 patients returned surveys: 351 (35%) were under surveillance, 657 (65%) had undergone repair (endovascular, 414; open, 179; unsure, 64). Median EIS was 11 (range 0–95; IQR 7–26). Median BCS was 13 (range 0–100; IQR 9–47). To test reliability, 337 patients repeated the survey after four weeks with no significant differences between scores over time. EIS and BCS demonstrated good internal consistency (Cronbach's Alpha 0.85 and 0.75 respectively). There was strong correlation between scores (r = 0.53) and both related moderately to SF-12 scores (r = 0.45 and r = 0.39, respectively). Patients under AAA surveillance had worse EIS than repair patients (22 vs. 13; p <.001). Patients with a higher perceived rupture risk had a worse EIS (45 vs. 12; p <.001) and BCS (30 vs. 13; p <.001). Conclusions: An AAA specific QOL instrument was successfully created and validated. The range of impact on QOL by AAA surveillance is broad. For most patients the impact is minimal, but for some, especially those with a greater perceived rupture risk, it is severe.
AB - Objective: The surveillance and treatment of abdominal aortic aneurysms (AAAs) may impact patient quality of life (QOL). A novel AAA specific QOL instrument was developed and validated to quantify the impact of AAA surveillance on QOL. Methods: The study was performed in two phases: development (2011–2013) and validation (2013–2014) of a survey instrument. Content was informed by focus groups at three centres (22 patients) and two multidisciplinary physician focus groups (6 vascular surgeons, 7 primary care providers). Cognitive interviews (17 patients) ensured questions were understood as intended. The final survey was mailed to AAA patients at six US institutions. Patients were scored on two AAA specific domains of QOL: emotional impact (EIS) and behavioural change (BCS), range 0–100 with higher scores indicating worse quality of life. Test retest reliability and internal consistency were assessed. Discriminant validity was determined by comparing scores between patients under surveillance vs. those who had undergone AAA repair. Scores were externally validated by correlation with the Short Form (SF)-12. Results: A total of 1,008 (73%) of 1,373 patients returned surveys: 351 (35%) were under surveillance, 657 (65%) had undergone repair (endovascular, 414; open, 179; unsure, 64). Median EIS was 11 (range 0–95; IQR 7–26). Median BCS was 13 (range 0–100; IQR 9–47). To test reliability, 337 patients repeated the survey after four weeks with no significant differences between scores over time. EIS and BCS demonstrated good internal consistency (Cronbach's Alpha 0.85 and 0.75 respectively). There was strong correlation between scores (r = 0.53) and both related moderately to SF-12 scores (r = 0.45 and r = 0.39, respectively). Patients under AAA surveillance had worse EIS than repair patients (22 vs. 13; p <.001). Patients with a higher perceived rupture risk had a worse EIS (45 vs. 12; p <.001) and BCS (30 vs. 13; p <.001). Conclusions: An AAA specific QOL instrument was successfully created and validated. The range of impact on QOL by AAA surveillance is broad. For most patients the impact is minimal, but for some, especially those with a greater perceived rupture risk, it is severe.
KW - Abdominal aortic aneurysm
KW - Quality of life
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U2 - 10.1016/j.ejvs.2019.01.018
DO - 10.1016/j.ejvs.2019.01.018
M3 - Article
C2 - 30803917
AN - SCOPUS:85061789972
SN - 1078-5884
VL - 57
SP - 809
EP - 815
JO - European Journal of Vascular and Endovascular Surgery
JF - European Journal of Vascular and Endovascular Surgery
IS - 6
ER -