UK Validation of the First Vascular Surgery Patient Reported Experience Measure (PREM): the PREMIERE Study

Area of Science:

• Vascular Surgery
• Patient Reported Experience Measures (PREMs)
• Psychometric Validation

Background:

• Patient experience is crucial in healthcare quality assessment.
• Existing measures may not adequately capture the nuances of vascular surgery patient journeys.
• Development of a specialized instrument is needed for accurate evaluation.

Purpose of the Study:

• To psychometrically validate a novel Patient Reported Experience Measure (PREM) specifically designed for vascular surgery.
• To establish the reliability, validity, and feasibility of the vascular surgery PREM.
• To provide a tool for patient-centered evaluation of vascular services.

Main Methods:

• The PREM was developed using a multiphase approach including systematic review, qualitative studies, patient interviews, and focus groups.
• Psychometric validation followed COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance.
• Evaluation included item reduction, factor structure analysis, internal consistency (Cronbach's α), construct validity, feasibility, and acceptability across three UK vascular units.

Main Results:

• A 22-item instrument was refined to a 14-item PREM, demonstrating high feasibility (>95% item completion, 7-min average completion time).
• Exploratory factor analysis supported a five-domain structure (information, shared decision-making, access, support, discharge) explaining 58.6% of variance.
• Acceptable internal consistency (α = 0.70–0.78) and significant correlations between PREM scores and clinical factors (hospital stay, admission type) were observed.

Conclusions:

• The vascular surgery-specific PREM is a concise, reliable, and valid instrument.
• It is feasible for routine clinical use and sensitive to meaningful variations in patient experience.
• The validated PREM supports patient-centered evaluation and quality improvement in vascular services.