CAMPHOR score: patient-reported outcomes are improved by pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension (CTEPH)

Michael Newnham; Katherine  Bunclark; Nisha  Abraham; Samantha  Ali; Liliana  Amaral-Almeida; John E  Cannon; Natalie  Doughty; Choo Ng; Anie  Ponnaberanam; Karen Sheares; Nicola  Speed; Dolores Taboada; Mark Toshner; Steven Tsui; David P  Jenkins; Joanna Pepke-Zaba

doi:10.1183/13993003.02096-2019

CAMPHOR score: patient-reported outcomes are improved by pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension (CTEPH)

Michael Newnham, Katherine Bunclark, Nisha Abraham, Samantha Ali, Liliana Amaral-Almeida, John E Cannon, Natalie Doughty, Choo Ng, Anie Ponnaberanam, Karen Sheares, Nicola Speed, Dolores Taboada, Mark Toshner, Steven Tsui, David P Jenkins, Joanna Pepke-Zaba

Applied Health Sciences

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Abstract

Background Pulmonary endarterectomy (PEA) is the recommended treatment for eligible patients with chronic thromboembolic pulmonary hypertension (CTEPH). The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) score is an internationally-validated patient-reported outcome (PRO) measure for CTEPH. It assesses 3 domains: activity, quality of life (QoL) and symptoms. We assessed PROs in patients with CTEPH undergoing PEA.
Methods This retrospective observational study of consecutive CTEPH patients undergoing PEA at the UK national PEA centre between 2006 and 2017 assessed change in CAMPHOR score from baseline (pre-PEA) until up to 5 years post-PEA. CAMPHOR scores were compared between (i) those with and without clinically significant residual PH and (ii) those undergoing PEA and propensity-matched CTEPH patients who were not operated on. The minimally clinically important difference (MCID) was calculated using an anchor-based method.
Results Of 1324 CTEPH patients who underwent PEA, 1053 (80%) had a CAMPHOR score recorded pre-PEA, 934 (71%) within a year of PEA and 784 (60%) had both. There were significant improvements between pre- and post-PEA in all three CAMPHOR domains (median ± interquartile range: activity, −5±7; QoL, −4±8; and symptoms, −7±8; p<0.0001, all). Improvements in CAMPHOR score were greater and more sustained in those without clinically significant residual PH. CTEPH patients undergoing PEA had better CAMPHOR scores than those not operated on. The MCID in CAMPHOR score was -3±5 for activity, -4±7 for QoL, and -6±7 for symptoms.
Conclusions PROs are markedly improved by PEA in patients with CTEPH, more so in those without clinically significant residual PH.

Original language	English
Article number	1902096
Journal	The European respiratory journal
Volume	56
Issue number	4
Early online date	8 Jun 2020
DOIs	https://doi.org/10.1183/13993003.02096-2019
Publication status	E-pub ahead of print - 8 Jun 2020

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine

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Newnham_et_al_CAMPHOR_score_European_Respiratory_Journal_2020
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Newnham, M., Bunclark, K., Abraham, N., Ali, S., Amaral-Almeida, L., Cannon, J. E., Doughty, N., Ng, C., Ponnaberanam, A., Sheares, K., Speed, N., Taboada, D., Toshner, M., Tsui, S., Jenkins, D. P., & Pepke-Zaba, J. (2020). CAMPHOR score: patient-reported outcomes are improved by pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension (CTEPH). The European respiratory journal, 56(4), Article 1902096. Advance online publication. https://doi.org/10.1183/13993003.02096-2019

@article{92d8e8ba5d784e128b830e1bd1a1d316,

title = "CAMPHOR score: patient-reported outcomes are improved by pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension (CTEPH)",

abstract = "Background Pulmonary endarterectomy (PEA) is the recommended treatment for eligible patients with chronic thromboembolic pulmonary hypertension (CTEPH). The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) score is an internationally-validated patient-reported outcome (PRO) measure for CTEPH. It assesses 3 domains: activity, quality of life (QoL) and symptoms. We assessed PROs in patients with CTEPH undergoing PEA.Methods This retrospective observational study of consecutive CTEPH patients undergoing PEA at the UK national PEA centre between 2006 and 2017 assessed change in CAMPHOR score from baseline (pre-PEA) until up to 5 years post-PEA. CAMPHOR scores were compared between (i) those with and without clinically significant residual PH and (ii) those undergoing PEA and propensity-matched CTEPH patients who were not operated on. The minimally clinically important difference (MCID) was calculated using an anchor-based method.Results Of 1324 CTEPH patients who underwent PEA, 1053 (80%) had a CAMPHOR score recorded pre-PEA, 934 (71%) within a year of PEA and 784 (60%) had both. There were significant improvements between pre- and post-PEA in all three CAMPHOR domains (median ± interquartile range: activity, −5±7; QoL, −4±8; and symptoms, −7±8; p<0.0001, all). Improvements in CAMPHOR score were greater and more sustained in those without clinically significant residual PH. CTEPH patients undergoing PEA had better CAMPHOR scores than those not operated on. The MCID in CAMPHOR score was -3±5 for activity, -4±7 for QoL, and -6±7 for symptoms.Conclusions PROs are markedly improved by PEA in patients with CTEPH, more so in those without clinically significant residual PH.",

author = "Michael Newnham and Katherine Bunclark and Nisha Abraham and Samantha Ali and Liliana Amaral-Almeida and Cannon, {John E} and Natalie Doughty and Choo Ng and Anie Ponnaberanam and Karen Sheares and Nicola Speed and Dolores Taboada and Mark Toshner and Steven Tsui and Jenkins, {David P} and Joanna Pepke-Zaba",

year = "2020",

month = jun,

day = "8",

doi = "10.1183/13993003.02096-2019",

language = "English",

volume = "56",

journal = "The European respiratory journal",

issn = "0903-1936",

publisher = "European Respiratory Society",

number = "4",

}

Newnham, M, Bunclark, K, Abraham, N, Ali, S, Amaral-Almeida, L, Cannon, JE, Doughty, N, Ng, C, Ponnaberanam, A, Sheares, K, Speed, N, Taboada, D, Toshner, M, Tsui, S, Jenkins, DP & Pepke-Zaba, J 2020, 'CAMPHOR score: patient-reported outcomes are improved by pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension (CTEPH)', The European respiratory journal, vol. 56, no. 4, 1902096. https://doi.org/10.1183/13993003.02096-2019

TY - JOUR

T1 - CAMPHOR score

T2 - patient-reported outcomes are improved by pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension (CTEPH)

AU - Newnham, Michael

AU - Bunclark, Katherine

AU - Abraham, Nisha

AU - Ali, Samantha

AU - Amaral-Almeida, Liliana

AU - Cannon, John E

AU - Doughty, Natalie

AU - Ng, Choo

AU - Ponnaberanam, Anie

AU - Sheares, Karen

AU - Speed, Nicola

AU - Taboada, Dolores

AU - Toshner, Mark

AU - Tsui, Steven

AU - Jenkins, David P

AU - Pepke-Zaba, Joanna

PY - 2020/6/8

Y1 - 2020/6/8

N2 - Background Pulmonary endarterectomy (PEA) is the recommended treatment for eligible patients with chronic thromboembolic pulmonary hypertension (CTEPH). The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) score is an internationally-validated patient-reported outcome (PRO) measure for CTEPH. It assesses 3 domains: activity, quality of life (QoL) and symptoms. We assessed PROs in patients with CTEPH undergoing PEA.Methods This retrospective observational study of consecutive CTEPH patients undergoing PEA at the UK national PEA centre between 2006 and 2017 assessed change in CAMPHOR score from baseline (pre-PEA) until up to 5 years post-PEA. CAMPHOR scores were compared between (i) those with and without clinically significant residual PH and (ii) those undergoing PEA and propensity-matched CTEPH patients who were not operated on. The minimally clinically important difference (MCID) was calculated using an anchor-based method.Results Of 1324 CTEPH patients who underwent PEA, 1053 (80%) had a CAMPHOR score recorded pre-PEA, 934 (71%) within a year of PEA and 784 (60%) had both. There were significant improvements between pre- and post-PEA in all three CAMPHOR domains (median ± interquartile range: activity, −5±7; QoL, −4±8; and symptoms, −7±8; p<0.0001, all). Improvements in CAMPHOR score were greater and more sustained in those without clinically significant residual PH. CTEPH patients undergoing PEA had better CAMPHOR scores than those not operated on. The MCID in CAMPHOR score was -3±5 for activity, -4±7 for QoL, and -6±7 for symptoms.Conclusions PROs are markedly improved by PEA in patients with CTEPH, more so in those without clinically significant residual PH.

AB - Background Pulmonary endarterectomy (PEA) is the recommended treatment for eligible patients with chronic thromboembolic pulmonary hypertension (CTEPH). The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) score is an internationally-validated patient-reported outcome (PRO) measure for CTEPH. It assesses 3 domains: activity, quality of life (QoL) and symptoms. We assessed PROs in patients with CTEPH undergoing PEA.Methods This retrospective observational study of consecutive CTEPH patients undergoing PEA at the UK national PEA centre between 2006 and 2017 assessed change in CAMPHOR score from baseline (pre-PEA) until up to 5 years post-PEA. CAMPHOR scores were compared between (i) those with and without clinically significant residual PH and (ii) those undergoing PEA and propensity-matched CTEPH patients who were not operated on. The minimally clinically important difference (MCID) was calculated using an anchor-based method.Results Of 1324 CTEPH patients who underwent PEA, 1053 (80%) had a CAMPHOR score recorded pre-PEA, 934 (71%) within a year of PEA and 784 (60%) had both. There were significant improvements between pre- and post-PEA in all three CAMPHOR domains (median ± interquartile range: activity, −5±7; QoL, −4±8; and symptoms, −7±8; p<0.0001, all). Improvements in CAMPHOR score were greater and more sustained in those without clinically significant residual PH. CTEPH patients undergoing PEA had better CAMPHOR scores than those not operated on. The MCID in CAMPHOR score was -3±5 for activity, -4±7 for QoL, and -6±7 for symptoms.Conclusions PROs are markedly improved by PEA in patients with CTEPH, more so in those without clinically significant residual PH.

UR - https://www.repository.cam.ac.uk/handle/1810/305360

U2 - 10.1183/13993003.02096-2019

DO - 10.1183/13993003.02096-2019

M3 - Article

SN - 0903-1936

VL - 56

JO - The European respiratory journal

JF - The European respiratory journal

IS - 4

M1 - 1902096

ER -

CAMPHOR score: patient-reported outcomes are improved by pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension (CTEPH)

Abstract

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