Development of a percutaneous coronary intervention patient level composite measure for a clinical quality registry
© 2020 The Author(s). Background: 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 compo...
| Main Authors: | , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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BMC
2020
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| Subjects: | |
| Online Access: | http://hdl.handle.net/20.500.11937/80060 |
| _version_ | 1848764152182472704 |
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| author | Ayton, D. Soh, S.E. Morello, R. Ahern, S. Earnest, A. Brennan, A. Lefkovits, J. Evans, S. Reid, Christopher Ruseckaite, R. McNeil, J. |
| author_facet | Ayton, D. Soh, S.E. Morello, R. Ahern, S. Earnest, A. Brennan, A. Lefkovits, J. Evans, S. Reid, Christopher Ruseckaite, R. McNeil, J. |
| author_sort | Ayton, D. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | © 2020 The Author(s).
Background: 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). Methods: 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. Results: 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). Conclusions: 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. |
| first_indexed | 2025-11-14T11:14:48Z |
| format | Journal Article |
| id | curtin-20.500.11937-80060 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:14:48Z |
| publishDate | 2020 |
| publisher | BMC |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-800602021-01-05T08:07:08Z Development of a percutaneous coronary intervention patient level composite measure for a clinical quality registry Ayton, D. Soh, S.E. Morello, R. Ahern, S. Earnest, A. Brennan, A. Lefkovits, J. Evans, S. Reid, Christopher Ruseckaite, R. McNeil, J. Science & Technology Life Sciences & Biomedicine Health Care Sciences & Services Composite measure Patient reported outcome Clinical outcome Percutaneous coronary intervention REPORTED OUTCOMES HEALTH PERFORMANCE © 2020 The Author(s). Background: 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). Methods: 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. Results: 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). Conclusions: 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. 2020 Journal Article http://hdl.handle.net/20.500.11937/80060 10.1186/s12913-019-4814-6 English http://creativecommons.org/licenses/by/4.0/ BMC fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Health Care Sciences & Services Composite measure Patient reported outcome Clinical outcome Percutaneous coronary intervention REPORTED OUTCOMES HEALTH PERFORMANCE Ayton, D. Soh, S.E. Morello, R. Ahern, S. Earnest, A. Brennan, A. Lefkovits, J. Evans, S. Reid, Christopher Ruseckaite, R. McNeil, J. Development of a percutaneous coronary intervention patient level composite measure for a clinical quality registry |
| title | Development of a percutaneous coronary intervention patient level composite measure for a clinical quality registry |
| title_full | Development of a percutaneous coronary intervention patient level composite measure for a clinical quality registry |
| title_fullStr | Development of a percutaneous coronary intervention patient level composite measure for a clinical quality registry |
| title_full_unstemmed | Development of a percutaneous coronary intervention patient level composite measure for a clinical quality registry |
| title_short | Development of a percutaneous coronary intervention patient level composite measure for a clinical quality registry |
| title_sort | development of a percutaneous coronary intervention patient level composite measure for a clinical quality registry |
| topic | Science & Technology Life Sciences & Biomedicine Health Care Sciences & Services Composite measure Patient reported outcome Clinical outcome Percutaneous coronary intervention REPORTED OUTCOMES HEALTH PERFORMANCE |
| url | http://hdl.handle.net/20.500.11937/80060 |