Patient reported outcome measures in patients with abdominal aortic aneurysms: a systematic review protocol

M Essat, E Poku, R Duncan, P Phillips, H Woods, S Palfreyman, G Jones, E Kaltenthaler and J Michaels

ABSTRACT

Background:
Abdominal aortic aneurysm (AAA) is a dilatation of the abdominal aorta, which is usually asymptomatic. However, rupture of the aneurysm can be fatal or require complex surgery with potential complications, leading to a poor quality of life. Patient reported outcome measures (PROMs) are becoming increasingly important in the current era of healthcare management. PROMs are used to directly assess how patients feel or function in relation to their health condition without any interpretation. Generic, disease-specific and preference-based PROMs can be used to assess the quality of life (QoL), symptoms and functional limitations in patients with AAA including those under surveillance or undergoing endovascular or open surgery or screening. However, these tools vary in terms of their reliability, validity and suitability for use in patients with AAA in a clinical setting.

Objectives:
To identify, summarise and assess PROMs that have been administered to patients with a diagnosis of AAA including those under surveillance or undergoing endovascular or open surgery or screening.

Methods:
Key electronic databases and research registers will be searched including: MEDLINE and MEDLINE in Process, EMBASE, PsycINFO, PROQOLID, CINAHL, PROMS Bibliography (Oxford University), Web of Science and the Cochrane Library databases from inception. A two-stage search approach will be used. The first stage will utilise general terms for PROMs to identify studies. These will be retrieved and the title and abstract will be examined for additional PROM terms. Stage 2 will incorporate these terms with the preliminary search strategy and a methodological search filter. Searches will be supplemented by hand-searching reference lists of relevant reviews and included studies. Study selection, data extraction and quality assessment will be performed independently by at least 2 reviewers. All English language instruments identified as PROMs for patients with AAA will be included. Data will be extracted regarding type of PROM, methods and results. Methodological quality of included studies will be assessed using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist (COSMIN) and the psychometric properties of the PROMs will be assessed on criteria based in published recommendations. Findings will be presented as narrative and tabular summaries.

Discussion:
This systematic review will identify PROMs that are used to assess QoL, symptoms and functional limitations in patients with AAA and assess their effectiveness for this population and application to clinical practice. The findings of the review will help inform a project examining the re-configuration of vascular services in the UK, and identify targets for future research.

Key words: Abdominal aortic aneurysm, Patient reported outcome measures, PROMs, quality of life