Tushar Garg, MD (he/him/his)
Postdoctoral Research Fellow
Johns Hopkins University School of Medicine
Disclosure information not submitted.
Clifford Weiss, MD, FSIR, FCIRSE
Professor of Radiology and Biomedical Engineering
Johns Hopkins Univeristy School of Medicine
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.
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).
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.