Postoperative Quality of Recovery Scale (PostopQRS)

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The Post-operative Quality of Recovery Scale (PostopQRS™) is a quick and easy-to-use web-based digital clinical outcomes assessment system (eCOA) that measures the quality of recovery of patients undergoing surgery and/or anaesthesia.

The Post-operative Quality of Recovery Scale (PostopQRS™) is a quick and easy-to-use web-based digital clinical outcomes assessment system (eCOA) that measures the quality of recovery of patients undergoing surgery and/or anaesthesia. The PostopQRS™ is clinician-led and provides objective assessment of post-operative recovery, analysing the core domains of recovery, namely physiologic, nociceptive, functional, cognitive and emotional recovery. PostopQRS™ is a digital measurement tool, that is CE Marked as a Class 1 Medical Device within the UK and Europe used to assess multiple domains of post-operative recovery over time. The PostopQRS™ can be administered as a pen and paper completion questionnaire too.

Background & Development

The quality of recovery following surgery and anaesthesia is of vital importance to improving patient outcomes and clinical practice.  “What happens in the operating room may influence recovery well beyond hospital discharge”. This concept guided the research started in 2007 by the group of international developers.

After comprehensive literature review, a pilot study on 133 patients lead to the refinement of the concepts to be measured by the PostopQRS™ in its domains and items. So, development was in accordance with sector good practices such as FDA guidance. The initial items were further tested in an observational study of 701 patients to assess the PostopQRS™ capacity to evaluate and track recovery and to discriminate between patients. The observational study was conducted in eight countries and in five languages, involving patients of 6 years of age and above undergoing elective surgery with general anaesthesia. Recovery was assessed before surgery and at multiple time periods postoperatively. Recovery was defined as return to baseline values or better.

A number of projects have since been performed to provide additional levels of validation in condition specific surgery such as knee replacement and arthroscopy, tonsillectomy, gastric and cardiac surgery.

Ongoing developments have included further validation studies to identify normal cognitive performance variability, as well as discriminant validation studies to show that the PostopQRS™ is able to:-

1)      discriminate change between groups,

2)      validation of use of the PostopQRS™ via the telephone,

3)      specific adjustments to take account of low cognitive performance prior to surgery.

In addition, there is a wealth of evidence on the measurement properties of the PostopQRS™ captured in over 30 peer reviewed international publications .

See external link listing all the 31 peer reviewed papers under ‘Key References’.

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Who is using the PostopQRS™?

The international PostopQRS™ userbase is made up of > 350 registered users in a variety of applications spread across the healthcare sector, but includes:-

Hospital clinicians and/or managers seeking to improve patient outcomes, optimise pathways, improve discharge data and help reduce readmissions.

Health outcome registry managers who are seeking a standardised measure to gather evidence of local, regional, national, or international surgical recovery outcomes.

Trial managers in (or eCOA service providers serving the needs of) the medical device or pharmaceutical sectors seeking to objectively evaluate and compare interventions over time.

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Key Features of the PostopQRS™

✔ Objective assessment of post-operative recovery

✔ Physiologic, nociceptive, functional, cognitive, emotional recovery domains assessed as well as overall patient perspective for a comprehensive assessment instrument

✔ Assessment of the effects of surgery from both clinician and patient perspectives, the PostopQRS™ is a powerful combination of PRO, ClinRo and PerfO delivering a comprehensive measure of recovery

✔ Repeated measures (n=4 recommended) allow for assessment over time, from immediate recovery to long-term follow up

✔ The PostopQRS™ can be used as an early warning system to failing recovery

✔ The PostopQRS™ is procedure agnostic and can be employed to assess recovery for elective, day, or ambulatory surgeries

✔ The PostopQRS™ be used to compare interventional outcomes – be it drug, device or procedure. This ability can be extended to the Benchmarking offering available from the PostopQRS™ team, where users can chose to share their (anonymised) results to have them benchmarked against other PostopQRS™ users.

✔ The PostopQRS™ has been shown to be valid for use with patients aged 6 years or older

✔ The PostopQRS™ is available in 11 languages, other translations are under development

✔ Easy to use

✔ Takes 5-6 minutes to complete

✔ Low patient refusal rate

✔ Multiple modes of deployment, but as a web-based version can be readily assessed using the respondent’s own device(s), be it tablet, smartphone or laptop, providing “Bring Your Own Device” (BYOD) user capability.

✔ Can be administered face-to-face or over the telephone – so responsive to remote capture

✔ The PostopQRS™ is classified as a Class 1, CE Marked Medical Device within the UK and EU

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Scoring System

Please contact us for details of how to submit your data for scoring and analysis.

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The PostopQRS™ has been designed to measure recovery over multiple time periods. It can be completed in 5-6 minutes by adults and children above age of 6.  The PostopQRS™ is available in 11 languages.

Although available in electronic format, the PostopQRS™ can legitimately be administered in paper-based format. Oxford University Innovation is authorised to grant licences for use of both the paper-based version and the electronic format of the PostopQRS™. The PostopQRS™ is available via an off the shelf platform on the PostopQRS™ website. Users can sign up for up to 5 free uses there. However you will need to indicate if you wish to use more during the application process.

PLEASE NOTE: paper and pen completed data will have to be entered in the PostopQRS™ website for scoring and analysis purposes.

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The development project was funded by a research grant from Baxter Healthcare (Deerfield, IL).

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