The Post-operative Quality of Recovery Scale (PostopQRS) is a digital measurement tool to quantify quality of recovery after surgery and anaesthesia. It is principally comprised of a number of questions that objectively measure patient recovery, which are clustered into five different domains (physiological, emotive, nociceptive, activities of daily living, and cognitive) and one self-assessment domain. It has been designed to measure recovery over multiple time periods.
The PostopQRS is conducted by utilising some commonly available hospital data and also an investigator asking a series of questions to the patient. These can be conducted face-to-face, or over the telephone. Typically, the baseline (pre-surgery) and in-hospital tests are performed face-to-face, but after hospital discharge, it can be conducted over the telephone.
It takes approximately 5 to 6 minutes to conduct the PostopQRS on each occasion.
Recovery means that the patient has returned to their pre-surgery state, or has improved from that. To quantify this, the post operative value for each test is subtracted from the baseline value, and if the difference is = 0 or negative, then the patient is scored as recovered. The exception to this rule is for the cognitive domain, where we introduce a tolerance factor to account for normal performance variability in cognitive tests. The patients can perform a little bit worse than baseline in the cognitive domain and still be scored as recovered. Recovery is then scored for each domain, and patients must recover in all tests within the domain to be scored as recovered. "All domains" recovery implies recovery in all of the five recovery domains. The self-assessment domain is not strictly a recovery domain as it does not have a baseline value. Rather, this domain is used to identify the patient's subjective opinions about the recovery process, including satisfaction.
The term “study” is used in the documents and on the website as a generic term to reflect any comparison a user would wish to make in the data. This would include any comparison between groups that the user would like to on the data they have gathered. This would include comparing hospitals, clinical teams, surgeons, types of surgery, different drugs used, different equipment and techniques of postop care etc.
All patients must have a pre-surgery PostopQRS assessment, as it captures the baseline state of the patient. After surgery, the investigator can determine when to measure recovery, according to the type of surgery, type of intervention, and length of follow-up that they wish to evaluate. Typically there are four major time periods of the valuation that will examine different aspects of recovery:
You will be able to export your data into a format that can be analysed using conventional statistical packages. Information on scoring recovery data is available on the members homepage. PostopQRS Ltd offers an additional advisory service on data analysis if required.
You can access free training and reference materials via the member’s portal. All tutorials are on the member's User home page.
In order to access the tool, you need to first request a licence to use the tool through the Clinical Outcomes team at Oxford University Innovation. If you are being invited to collaborate on a study as part of a group, you do not need a separate licence. You can then sign up as a registered User and accept the terms and conditions. of using the online tool.
Wherever possible we seek your permission for us to analyse your anonymous data. This will allow us to produce benchmark data for different treatments. It will also, in time, provide an additional service, as you will be able to compare how your centre/technique compares with national or international Outcome data.
Once you sign-up to PostopQRS-online, you will have access to a primary dataset including patient demographics and surgical and anaesthetic details. You can also add your own specific questions. If you choose to add questions, then you would need to record that separately in your own spreadsheet or database, and simply use the PostopQRS website to enter data for the PostopQRS tool.
In order to get access to the PostopQRS materials, you will need to sign up as a User and accept the terms and conditions of use. You will then have access to entering the data, as well as to the training package. It is important, that all Users of the PostopQRS read through and become familiar with the training package. This is designed to improve consistency of use with the tool. In the training package, there is a step-by-step guide on how to enter the data. Resources such as the "Faces Chart" can be downloaded and printed by Users to give to patients.
The data entry is designed for either an individual User, or a group of Users wherever their geographic location. When you set up your user profile, you will be able to assign other members working with you to use the tool. This will allow you and those you wish to work with you to access your data entry as well as analysis.
Users are restricted to seeing their own data only. We are developing benchmark data for different procedures. All data output will be de-identified, other than the country of origin. All data entry to the PostopQRS must be de-identified at the point of data entry. This provides privacy protection to patients and satisfies data protection procedures. You will need to keep any re-identifying records securely within your own database or filing system.
Basic information regarding your data can often be sourced from your local institution. However, if you have questions specifically related to the PostopQRS, please send us an email through the Contact us tab. This will be forwarded to one of the members of the PostopQRS Ltd team who will contact you to discuss your query.