Introduction Ascites is the most common complication of cirrhosis, but tools to assess its impact on Health Related Quality of Life (HRQoL) are limited. The Newcastle Patient Reported Ascites Measure (N-PRAM) was developed to measure the multidimensional impact of ascites on HRQoL.
Methods Structured interviews were carried out with patients with ascites and hepatologists and a long-list of twenty items was produced. These items were assessed for appropriateness and clarity by a further ten patients and the resulting tool was reduced to nine items. Initial validation was carried out on 25 patients with ascites from a multicentre UK study of quality of life in cirrhosis.
Results The 9 items tested the following areas: abdominal pain, abdominal discomfort, abdominal bloating, shortness of breath, movement, ill-fitting clothes, self-image, early satiety and ankle swelling.
Construct validity: inter-item correlations were good (r > 0.6) except for the ankle swelling item. Internal consistency, tested using Cronbach’s alpha coefficient (a), was 0.955 and improved to 0.958 after removing the ankle swelling item.Concurrent validity: The correlation between the CLDQ-Abdominal Symptoms scale and each N- PRAM item score (r range -0.653 to -0.358) was low to moderate.
Conclusion The 8 item Newcastle Patient Reported Ascites Measure is an effective HRQoL measure which has been validated in English. It provides a more detailed assessment of HRQoL in ascites than other available tools, such as CLDQ, and would therefore be a suitable outcome measure for use in future studies of ascites management.
Disclosure of Interest None Declared.
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