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Author Notes:

Email: Judith.white3@wales.nhs.uk

The authors thank Peter O’Callaghan (Cardiology Dept., Cardiff and Vale UHB), Stephen Murray (Cardiology Dept., Newcastle Upon Tyne Hospitals NHS Foundation Trust), and Racheal James (Cardiology Dept., Cardiff and Vale UHB) for patient enrolment, Ann James (Cedar, Cardiff and Vale UHB) for administrative support and data entry.

The authors declare that they have no conflict of interest.


Research Funding:

This work was supported by the National Institute for Health and Care Excellence (NICE). Cedar, Cardiff and Vale University Health Board (institution of JW, KW, AW, GCR) is funded by NICE to act as an external assessment centre.

This study was conducted as part of Cedar’s contract to provide services to NICE.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Health Care Sciences & Services
  • Health Policy & Services
  • Public, Environmental & Occupational Health
  • Cardiac ablation
  • Quality of life (QoL)
  • Patient-reported outcome measures (PROMs)
  • Arrhythmia
  • Validation
  • Questionnaires

Cardiff cardiac ablation patient-reported outcome measure (C-CAP): validation of a new questionnaire set for patients undergoing catheter ablation for cardiac arrhythmias in the UK


Journal Title:

Quality of Life Research


Volume 25, Number 6


, Pages 1571-1583

Type of Work:

Article | Final Publisher PDF


Purpose: To formally test and validate a patient-reported outcome measure (PROM) for patients with cardiac arrhythmias undergoing catheter ablation procedures in the UK [Cardiff Cardiac Ablation PROM (C-CAP)]. Methods: A multicentre, prospective, observational cohort study with consecutive patient enrolment from three UK sites was conducted. Patients were sent C-CAP questionnaires before and after an ablation procedure. Pre-ablation C-CAP1 (17 items) comprised four domains: patient expectations; condition and symptoms; restricted activity and healthcare visits; medication and general health. Post-ablation C-CAP2 (19 items) comprised five domains including change in symptoms and procedural complications. Both questionnaires also included the generic EQ-5D-5L tool (EuroQol). Reliability, validity, and responsiveness measures were calculated. Results: A total of 517 valid pre-ablation and 434 post-ablation responses were received; questionnaires showed good feasibility and item acceptability. Internal consistency was good (Cronbach’s alpha > 0.7) and test–retest reliability was acceptable for all scales. C-CAP scales showed high responsiveness (effect size > 0.8). Patients improved significantly (p  <  0.001) following ablation across all disease-specific and global scales. Minimal clinically important difference was calculated. Improvement beyond the smallest detectable change of 9 points (symptom severi ty scale), 3 points (frequency and duration of symptoms scale), and 8 points (impact on life scale) indicates an important change. Amendments to the C-CAP questionnaires were identified through the validation process and made to produce the final tools. Conclusions: The final C-CAP questionnaires are valid, reliable, and responsive tools for measuring symptom change, impact, and expectations in patients undergoing ablation for cardiac arrhythmias. C-CAP questionnaires provide a tool with disease-specific and generic domains to explore how cardiac ablation procedures in the UK impact upon patients’ lives.

Copyright information:

© 2016, The Author(s).

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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