The Experience of Patients During the Clinical Management Pathway of Abdominal Aortic Aneurysms at a NHS Trust

Lee, Regent; Jones, Amy; Woodgate, Felicity; Bellamkonda, Kirthi S.; Killough, Nicholas; Fulford-Smith, Lucy; Hurst, Katherine; Cassimjee, Ismail; Handa, Ashok

doi:10.1177/2374373517715010

Cited by 7 publications

(7 citation statements)

References 14 publications

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“…This review shows that only three studies specifically address the impact of follow up and potential re-interventions on a patient's perspective of QoL. 53,58,59 One emerging conclusion is that, in contrast, to general assumptions, patients experience follow up as reassuring. In fact, patients report that dissatisfaction with follow up was due to a lack of follow up after OR rather than to excessive follow up after EVAR.…”

Section: Discussionmentioning

confidence: 99%

“…Two qualitative studies addressed the patients' attitudes towards the possibility of a reintervention in elective repair. 58,59 It was concluded that the possibility of a re-intervention influenced the choice of repair (i.e., patients preferred to not have a re-inter vention). No qualitative study specifically addressed the impact on QoL of an actual re-intervention.…”

Section: The Impact Of Follow Up On Quality Of Lifementioning

confidence: 99%

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Towards Patient Centred Outcomes for Elective Abdominal Aortic Aneurysm Repair: A Scoping Review of Quality of Life Scales

Bulder

Hamming

Schaik

et al. 2021

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDS This paper adds an inventory of available literature on quality of life (QoL) assessment in elective abdominal aortic aneurysm repair and points out the missing aspects that should be addressed in further research to adequately implement the patient's perspective on QoL in treatment outcomes.Objective: In order to better incorporate the patient's perspective in medical decision making, core outcome sets (COS) are being defined. In the field of abdominal aortic aneurysm (AAA), efforts to capture the patient's perspective focus on generic quantitative quality of life (QoL) scales. The question arises whether these quantitative scales adequately reflect the patient's perspective on QoL, and whether they can be included in the QoL aspect of COS. A scoping review of QoL assessment in the context of elective AAA repair was undertaken. Data Sources: PubMed, Embase, Web of Science, and the Cochrane Library. Review Methods: A scoping review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Articles reporting QoL assessment in the context of elective AAA repair were identified. Quantitative studies (i.e., traditional QoL scales) were aligned (triangulation approach) with qualitative studies (i.e., patient perspective) to identify parallels and discrepancies. Mean Short Form 36 item survey (SF-36) scores were pooled using a random effects model to evaluate sensitivity to change. Results: Thirty-three studies were identified, of which 29 (88%) were quantitative and four (12%) qualitative. The 33 studies reported a total of 54 quantitative QoL scales; the most frequently used were the generic SF-36 (16 studies) and five dimension EuroQol (EQ-5D; eight studies). Aneurysm specific scales were reported by one study. The generic quantitative scales showed poor alignment with the patient's perspective. The aneurysm specific scales better aligned but missed "concerns regarding symptoms" and "the impact of possible outcomes/ complications". "Self control and decision making", which was brought forward by patients in qualitative studies, was not captured in any of the current scales. Conclusion:There is no established tool that fully captures all aspects of the patient's perspective appropriate for a COS for elective AAA repair. In order to fulfil the need for a COS for the management of , AAA disease, a more comprehensive overview of the patient's perspective is required.

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Section: Discussionmentioning

confidence: 99%

Section: The Impact Of Follow Up On Quality Of Lifementioning

confidence: 99%

Towards Patient Centred Outcomes for Elective Abdominal Aortic Aneurysm Repair: A Scoping Review of Quality of Life Scales

Bulder

Hamming

Schaik

et al. 2021

European Journal of Vascular and Endovascular Surgery

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“…This may be due to a better understanding of the importance of surveillance. Patients who had AAA repair may feel that they are disease free 31 and therefore do not need more treatment. As a result, patients may fail to appreciate the importance of surveillance and become non-compliant.…”

Section: Discussionmentioning

confidence: 99%

Multicentre Post-EVAR Surveillance Evaluation Study (EVAR-SCREEN)

Karthikesalingam¹,

Holt²

2019

European Journal of Vascular and Endovascular Surgery

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“…This was further underpinned by the fact that 52% of the respondents felt highly preoccupied by the size of their AAAs. 13 …”

Section: Discussionmentioning

confidence: 99%

Applied Machine Learning for the Prediction of Growth of Abdominal Aortic Aneurysm in Humans

Lee

Jarchi

Perera

et al. 2018

EJVES Short Reports

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ObjectiveAccurate prediction of abdominal aortic aneurysm (AAA) growth in an individual can allow personalised stratification of surveillance intervals and better inform the timing for surgery. The authors recently described the novel significant association between flow mediated dilatation (FMD) and future AAA growth. The feasibility of predicting future AAA growth was explored in individual patients using a set of benchmark machine learning techniques.MethodsThe Oxford Abdominal Aortic Aneurysm Study (OxAAA) prospectively recruited AAA patients undergoing the routine NHS management pathway. In addition to the AAA diameter, FMD was systemically measured in these patients. A benchmark machine learning technique (non-linear Kernel support vector regression) was applied to predict future AAA growth in individual patients, using their baseline FMD and AAA diameter as input variables.ResultsProspective growth data were recorded at 12 months (360 ± 49 days) in 94 patients. Of these, growth data were further recorded at 24 months (718 ± 81 days) in 79 patients. The average growth in AAA diameter was 3.4% at 12 months, and 2.8% per year at 24 months. The algorithm predicted the individual's AAA diameter to within 2 mm error in 85% and 71% of patients at 12 and 24 months.ConclusionsThe data highlight the utility of FMD as a biomarker for AAA and the value of machine learning techniques for AAA research in the new era of precision medicine.

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The Experience of Patients During the Clinical Management Pathway of Abdominal Aortic Aneurysms at a NHS Trust

Cited by 7 publications

References 14 publications

Towards Patient Centred Outcomes for Elective Abdominal Aortic Aneurysm Repair: A Scoping Review of Quality of Life Scales

Towards Patient Centred Outcomes for Elective Abdominal Aortic Aneurysm Repair: A Scoping Review of Quality of Life Scales

Multicentre Post-EVAR Surveillance Evaluation Study (EVAR-SCREEN)

Applied Machine Learning for the Prediction of Growth of Abdominal Aortic Aneurysm in Humans

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