Use of Registry Data to Evaluate Patient-reported Outcome Measures in the Management of Atrial Fibrillation
The research questions were based on the revised Wilson and Cleary framework (Wilson & Cleary, 1995) with adaptations made by Spertus et al. (2002). In this framework, biological function (e.g., AF type, urgency status, stroke risk score, and diagnosis) influences clinician-reported symptoms (e.g., Severity in AF scale), which in turn affects patient-reported health (e.g., AF Effect on QualiTy-of-life or AFEQT). The impact of each of these domains is further modified by individual and environmental characteristics (e.g., age, gender, and distance to AF clinic). The established conceptual framework is supplemented by the conceptualisation of treatment as a component of biological function. The treatment component includes medication and ablation. This framework may help to facilitate a more comprehensive approach to patient care because it integrates the biopsychosocial perspective into a single framework.
The purpose of this study is to use registry data to evaluate PROMs in the management of AF. Based on the conceptual framework, the research questions are:
1. Can the trajectories of change in patient-reported outcome measures for outpatients with atrial fibrillation be explained by different biological functioning, or individual and environmental characteristics?
2. What is the concordance between patient- and clinician- reported outcome measures for outpatients with atrial fibrillation?
Hypothesis 1: Patient-reported outcome measures will be lower among patients who are older, female, live further away from an atrial fibrillation clinic, have persistent atrial fibrillation, have urgent status, have higher stroke risk score, have multiple co-morbidities, report more frequent episodes of AF, do not have ablation compared to those who are younger, male, liver closer to an atrial fibrillation clinic, have paroxysmal atrial fibrillation, have an elective status, have lower stroke risk score, have fewer co-morbidities, report less frequent episodes of AF, and have an ablation.
Hypothesis 2: There is a weak positive relationship between changes in patient-reported outcome measure and changes in clinician-reported outcome measure.