Key result
Baseline patient-reported outcome questionnaires were less likely to be obtained from older CABG patients (OR 0.51; 95% CI 0.28-0.91) and those with more severe disease.
Why the study?
Are routinely collected patient-reported outcomes representative of the actual case-mix in elective coronary revascularization patients?
Observational (n=1,142)
No
Are routinely collected patient-reported outcomes representative of the actual case-mix in elective coronary revascularization patients?
Odds Ratio: 0.51 (95% CI 0.28–0.91)
Routinely collected patient-reported outcomes in cardiac patients may be biased towards younger and healthier individuals, highlighting the need for adequate resourcing to ensure representative data collection.
May bias routinely collected PROs toward younger, healthier patients; leaves open whether they represent actual case-mix in elective revascularization.
Aims: Patient-reported outcomes (PROs) are valuable for effectiveness evaluation, but it is unknown whether the patient views obtained represent the actual case mix. We studied the representativeness of the responses obtained to a routinely administered health-related quality of life (HRQoL) questionnaire in a cardiology unit. Methods and results: Elective coronary artery bypass grafting (CABG; n = 404) and percutaneous coronary intervention (PCI; n = 738) patients operated during June 2012 to August 2014 in the Heart Center, Kuopio University Hospital. The characteristics of the patients with a baseline (n = 260 and 290 for CABG and PCI, respectively) or both baseline and follow-up HRQoL measurements (n = 203 and 189 for CABG and PCI, respectively) were compared with those who did not respond (n = 144 and 448 for CABG and PCI). Baseline questionnaires were less likely obtained from older CABG patients (odds ratio 0.51, 95% confidence interval 0.28-0.91) and those with more severe disease (0.20, 0.05-0.79). Among PCI patients, women (0.64, 0.45-0.91), smokers (0.74, 0.53-1.04), and those with more severe disease (0.26, 0.13-0.52) or more hospital days were underrepresented. Conclusion: Routinely collected PROs in cardiac patients may be biased towards younger and healthier patients. This needs to be recognized when evaluating the representativeness of such data. The routine collection of these data should be adequately resourced.
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Oinasmaa et al. (2017) conducted an observational in Elective coronary revascularization (n=1,142). Older age (in CABG patients) vs. Younger age was evaluated on Obtaining baseline HRQoL questionnaires (OR 0.51, 95% CI 0.28-0.91). Baseline patient-reported outcome questionnaires were less likely to be obtained from older CABG patients (OR 0.51; 95% CI 0.28-0.91) and those with more severe disease.
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