Patient perceptions after AAA repair, by Anna Corby

Anna Corby

OUH

service evaluation about care they get after AAA repair

published study by Lee 2017: how satisfied were you with your care on the ward. AAA. 79% very satisfied. 13% acceptable. 8% not satisfied.

Primary Outcome: To understand experiences and attitudes of patients after their IP care for AAA repair, either by open surgery or EVAR.

Inclusion criteria: Capacity present, age Over 18, Has an elective AAA repair

Study done 1-2 weeks after discharge: qualitiative and quantitative study.

3 things for open ended questionnaire

Confidence in staff; Info provided; Environment

Secondary: what difference between pt groups

a) is there a difference between groups in the quanitative reponse based on 15 item SF

b) is there a difference in themes the two groups come up with in the qualitative study

Qn: do you want to add in the experience from the surveillance? Answer: This aspect has already been well documented in publications.

Prevalence of DVT in patients with lower limb cellulitis, by Gabriel Santos.

Gabriel Santos RFH

Nice touch with the research qn staying in the header

Is there a need to improve the DVT clinical prediction tool for patients with cellulitis?

Currently 2 level Wells score

Cellulitis over-estimates the Wells score

Cellulitis also raises the D dimer score

RoL - the likelihood of concurrent DVT with cellulitis was in the range of 0.5% to 1%.

Based on these deciding to do a retrospective service evaluatoin

Intending to use the outome as a pilot study for power calculation for future research. With a view to modifying the wells score for patients with cellulitis.

Qn: Would the diagnosis of cellulitis be a clinical one.

Good question.

Qn: new cellulitis versus non resolving cellulitis

Yes good

QN: IP vs OP

Good answer: concurrence vs. causal.

Using Google maps to measure IC distance, by Zina Benbia.

Zina Benbia

Google maps

Using google street view

Primary objective: to establish agreement between Google Street View and walk test / self reported distances

Secondary: Understand feasibility

going to do self reported SR-onset and SR-max of IC

start at address, or

use landmark on GSV to start walk

landmark for SR-o and SR-max

Corridor walking test -lengths at normal place till max pain

LIkert of how easy each of the 3 types was

QNS: VNS could use this. How about Strava too?

Yes, other specialties too, like respiratory do a lot of walking tests.

Audit on compliance with 2017 ESVS pre op carotid imaging guidance, by Emily Alderson.

Emily Alderson

ESVS 2017 guidance clarified: stated as either 2 forms of imaging, or duplex repeated by different operators.

Objectives:

1) check compliance: did a pilot check and found 71.4% Jan to Jun 2019 6 month check

2) Explore reasons for non compliance

3) re-audit

Method

Got data from NVR

Found Jan 2019 to Dec 2021 = 205 CEAs in 3 years

EPIC used to identify all needed info: demographics, referrals, etc.

SPSS for analysis

Overall 87.3% compliant with guideline.

No difference between hub and spoke referrals

Checked between referral pathways arising from the stroke team or not = no differences in compliance

Checked whether only 1 scan were for mainly those who had their CEA done within 14 days: No difference

Did Covid have an impact, looked March 2020 - 2021; turned out to be in CV19 there were 94% that had compliance.

Checked this above figure again to ensure was not just a case of better compliance with progressing years; not, therefore - >

Relationship was unique to Covid and not to progression over years.

Future considerations:

Pathway mapping.

MDTM input missing? There is one bitsaying MDT theatre list review.

Multifaceted pathway.

I offered comments: Excellent work. Particularly I meant the focus on ferreting out the cover data. Also meant the attention to detail in checking if not due to 14 day target etc. Later on in discussion in response to another qn also clarified that not based on one or two consultant outliers.

I asked if worth knowing specifically about discrepancies between CTA / MRA vs. duplex rather than just the compliance within guidelines (gave clinical examples). EK has this data and is intending to look through.

Feasibility of AI application in vascular ultrasound reporting, by Lizzie Washak

AI assisted software in reporting vascular US

Researched and found a company with FDA CE approved AI reporting software

Reesarch study looking at SFA

1) what is the agreement among the following 3: AI, clinical scientist reported duplex and CTA

2) how much time is it going to take

Using only SFA

Cohens Kappa for ageements

Unpaired T test for the secondary aims

Delay with the project due to both IPR as well as logistics

Mean growth rate of popliteal aneurysms on U/S, by Sandra Piatkowska.

5 year retrospective local data set analysis

Gloucestershire

0.1-3% of adults affected by Pop AA

Mostly men

There is currently no consensus on optimal Pop AA surveillance interval or threshold

Locally it is set by consultant on a pt to pt basis

Consideration of cost effectiveness vs patient risk

Primary aim of the study:

Local average growth rate over the past 5 years

Secondary aim:

Identify factors that affect growth rate: Having a concurrent AAA, HTN, DM, Smoking, Statins and anti-thrombotic meds

Going to have inclusion criteria as minimum 2 scans

Methods of analysis will be

linear regressin for local growth rate and linear multiregression for individual patient growth rate

Audience suggestion: use logarithmic scale analysis because bigger they get faster they grow