Article Text

Download PDFPDF

Original research article
Using patient-reported outcome measures for primary percutaneous coronary intervention
  1. Esther Kwong1,
  2. Jenny Neuburger1,
  3. Steffen Erhard Petersen2,3 and
  4. Nick Black1
  1. 1 Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
  2. 2 William Harvey Research Institute, Queen Mary University of London, London, UK
  3. 3 Barts Heart Centre, Barts Health NHS Trust, London, UK
  1. Correspondence to Dr Esther Kwong; esther.kwong{at}


Introduction Routine measurement of the outcome of myocardial infarction is usually limited to immediate morbidity and mortality. Our aim was to determine the response to patient-reported outcome measures (PROMs) 3 months later, identify response bias and explore the feasibility of comparing outcome with their recalled view of their prior health state.

Methods Patients admitted with ST-segment-elevation myocardial infarction (STEMI) to five percutaneous coronary intervention centres were invited to complete a retrospective questionnaire containing the EQ-5D-3L and short form Seattle Angina Questionnaire (SAQ-7). Response rate for a 3-month mailed follow-up questionnaire and potential response biases were assessed. Patients’ outcomes were compared with their baseline using χ2 and paired t-test to assess for differences.

Results Of 392 patients contacted, 260 (66.3%) responded. Responders were more likely to be older, female, more affluent and have a higher EQ-5D at baseline. Three months after surgery, patients’ SAQ-7 and angina symptom subscale returned to their baseline score. The physical limitation subscale score was worse than at baseline (79.9 vs 73.2, p=0.002), whereas the quality-of-life subscale was better (66.6 vs 73.9; p<0.001). The EQ-5D-3L index score was similar at 3 months to baseline (0.82 vs 0.79). Evidence of bias arising from responders being in better general health at baseline needs further investigation and, if confirmed, needs to be taken into account in interpreting PROMs data.

Conclusion It is feasible to use PROMs routinely to assess the impact of emergency admissions of patients with STEMI. A larger demonstration project with more sites is needed to confirm these findings.

  • patient reported outcome measures
  • health status
  • health-related quality of life
  • retrospective
  • response rate
  • feasibility
  • emergency admissions
  • AMI

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • STEMI PROMs site and study leads Julie Saunders, Mervyn Andiapen, Amy Richards, Mark Vertue, Joanne Riches, Jonathan Breeze, Amy Hoare, Alison Pottle, Paula Rogers, Claire Prendergast, Karen Wilson, Kirsty Gibson.

  • Contributors EK was the principal investigator of the study. NB is the doctoral supervisor. EK and NB wrote the paper with input from JN and SEP.

  • Funding EK is funded by Economic and Social Research Council doctoral fellowship. Grant reference: ES/J500021/1. The research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care North Thames at Barts Health NHS Trust.

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee (NHS Health Research Authority) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study received NHS ethical approval from South East Coast—Brighton and Sussex Research Ethics Committee (REC reference: 16/LO/2053) and was incorporated in the NIHR Research Network Portfolio.

  • Provenance and peer review Not commissioned; externally peer reviewed.