Chen, Y;
Nagendran, M;
Gomes, M;
Wharton, PV;
Raine, R;
Lambiase, PD;
(2020)
Gaps in patient reported outcome measures in randomised clinical trials of cardiac catheter ablation: a systematic review.
European Heart Journal: Quality of Care and Clinical Outcomes
, 6
(4)
pp. 234-242.
10.1093/ehjqcco/qcaa022.
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Abstract
Aims: To systematically evaluate randomised clinical trials of cardiac catheter ablation and to assess the prevalence, characteristics and reporting standards of clinically relevant patient reported outcome measures (PROMs). / Methods and Results: Electronic database searches of Medline, Embase, CENTRAL and the WHO Trial Registry were conducted in March 2019. The study protocol was registered on PROSPERO (CRD42019133086). Of 7,125 records identified, 237 RCTs were included for analysis, representing 35,427 patients with a mean age of 59 years. Only 43 RCTs (18%) reported PROMs of which 27 included a generic PROM that measured health-related quality of life (HRQL) necessary to conduct comparative effectiveness research. There was notable under-representation of certain patient groups - only 31% were women and only 8% were of non-Caucasian ethnicity, in trials which reported such data. The reporting standard of PROMs was highly variable with 8-62% adherence against CONSORT PRO specific items. / Conclusion: PROMs play a crucial role in determining the clinical and cost effectiveness of treatments which primarily offer symptomatic improvement, such as cardiac catheter ablation (CCA). Their underuse significantly limits evaluation of the comparative effectiveness of treatments. Using CCA as an exemplar, there are additional issues of infrequent assessment, poor reporting and under-representation of many population groups. Greater use of PROMs, and specifically validated HRQL questionnaires, is paramount in giving patients a voice in studies, generating more meaningful comparisons between treatments and driving better patient-centred clinical and policy-level decision making.
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