SUPPORTING THE ROUTINE COLLECTION OF PATIENT REPORTED OUTCOME MEASURES IN THE NATIONAL CLINICAL AUDITS FOR ASSESSING COST EFFECTIVENESS Work Package 1 - What patient reported outcome measures should be used in the 13 health conditions specified in the 2013/14 National Clinical Audit programme? Appendix K, Cardiovascular Disease

1. BACKGROUND

EEPRU was approached by Jason Cox (R&D Division) to prepare a programme of research to support the appropriateness of, and use of, patient reported outcome measures (PROMs) collected for the National Clinical Audit (NCA). The EEPRU programme was informed by a R&D template prepared by Simon Bennett, Steve Fairman and Keith Willett at NHS England.

The purpose of introducing PROMs into the NCA programme is to be able to 1) compare performance between providers and commissioners in the National Health Service (NHS), 2) compare the cost-effectiveness of alternative providers in delivering the specific services (i.e. linking outcomes and resource use), and 3) assess the cost-effectiveness of alternative interventions and other changes in the NHS. The intention is to introduce PROMs across a range of conditions over the next 3 years commencing with 13 conditions in the 2014/15 NCA programme.

The agreed research programme consists of 3 concurrent work packages (WP) as described in the document submitted to the DH (8th November 2013). The current document provides details on the objectives, methodology and results for Work Package 1 (WP1): to determine what PROMS should be used in the 13 health conditions specified in the 2014/15 NCA programme.

2. OVERVIEW

WP1 is split into three separate components consisting of:

WP1.1 To examine whether the EQ-5D is appropriate in the 13 health conditions specified in the 2013/14 NCA programme.

WP1.2 To identify what measure could be used when the EQ-5D is not appropriate in the 13 health conditions, taking into account that the proposed measure would be used to generate preference-based utility measures (either directly through existing preference-based weights, or indirectly through existing mapping functions suitable for the proposed measure).

WP1.3 To identify the evidence required to address questions of cost-effectiveness using the NCA data.

Each component consists of a series of reviews of the literature.

This Appendix provides the detailed results for the cardiovascular disease (CVD), which include cardiac arrhythmia, heart failure (HF), coronary angioplasty, cardiac surgery and acute coronary

EEPRU NCA Appendix K: Cardiovascular Disease syndrome (ACS), and should be read in conjunction with both the main report and the methods/search strategy appendices.

3. METHOD

The full detailed methodology used is provided in Appendix A, including the search strategy, selection criteria for studies included, and data extraction etc. In summary, for each included cardiovascular condition a review of the literature was undertaken to assess the appropriateness of the EQ-5D in terms of classic psychometric criteria (WP1.1); where the EQ-5D was not considered appropriate, additional searches were undertaken to identify alternative measures (WP1.2); and finally, existing health technology appraisals were reviewed and data requirements were compared with variables currently collected in the CVD audits (WP1.3).