Mixed-Methods Assessment of the Patients-Reported Outcome Measure for Vascular Malformations Questionnaire (PROVAM) in Patients with Low-Flow Vascular Malformations: A Prospective Cohort Study

Monday, March 6, 2023

12:00 PM – 1:00 PM

Location: Phoenix Convention Center, North Ballroom 120 D

Poster Presenter(s)

Tushar Garg, MD (he/him/his)

Postdoctoral Research Fellow
Johns Hopkins University School of Medicine

Disclosure information not submitted.

Author/Co-author(s)

Natalie Y. Ring, MD

Resident
Johns Hopkins University
CW

Clifford Weiss, MD, FSIR, FCIRSE

Professor of Radiology and Biomedical Engineering
Johns Hopkins Univeristy School of Medicine

Disclosure(s):

Clifford Weiss, MD, FSIR, FCIRSE: Boston Scientific: Consultant (Ongoing), Intellectual Property Rights (Ongoing), Research Grant Recipient (Ongoing); Guerbet: Research Grant Recipient (Ongoing); Medtronic: Consultant (Ongoing), Research Grant Recipient (Ongoing); Siemens Healthineers: Consultant (Ongoing), Research Grant Recipient (Ongoing)

Purpose:

To assess the concordance between the qualitative and quantitative responses by the patients with low-flow vascular malformations (VMs) using a validated Patients-Reported Outcome Measure for Vascular Malformations Questionnaire (PROVAM).

Materials and Methods:

From 7/2019 to 2/2022, 327 consecutive patients completed 439 PROVAM surveys at our vascular anomalies clinic. The 30-item instrument includes three separate assessment scores, pain assessment score (PAS, range 6-50), emotional and social impacts assessment score (ESS, range 4-20), and physical function assessment score for upper extremity, lower extremity, and trunk (PFS ULT, range 4-20) and head & neck (PFS H&N, range 5-25). Patient responses to a free text question asking about their most bothersome symptom were evaluated using a directed content analysis approach, and there were categorized into three conceptual domains of PROVAM: physical (PD), emotional/social well-being (ESD), functional impact [H&N; ULT] (FD). The different assessment scores were compared between patients belonging to these domains using a one-way ANOVA and unpaired t-test.

Results:

The median (IQR) for the PAS, ESS, PFS ULT and PFS H&N was 19 (10-29), 8 (6-12), 10 (6-15), and 7 (5-10), respectively. The domains affected in these patients involved most commonly the PD (261/323; 80.8%), followed by ESD (52/323; 16.1%) and FDs (H&N, 15/323; 4.6% vs. ULT, 46/323; 14.2%). The PAS was different in patients across domains (p< .001), and it was higher in those that felt the PD (median 23 vs. 15, p=.003) and FD ULT (median 25 vs. 15, p=.01) was affected compared to those with ESD affected. Similarly, the PFS ULT was different in patients across domains (p=.002), and it was higher in those that felt the PD (median 10 vs. 7.5, p=< .002) and FD ULT (median 12 vs. 7.5, p=.001) was affected compared to those with ESD affected. The ESS and PFS H&N were similar across patients with different domains affected (p=.61, .73).

Conclusion:

This study demonstrated concordance between the PAS and PFS ULT parts of PROVAM; however, further questions need to be added to the ESS and PFS H&N items to add quantitative scores for factors that can affect ESD and FD H&N.