Data Linkage and Extract
Service
Patient Reported Outcome Measures
(PROMs) Data Form
PROMs application form
Introduction
This data form allows you to request an extract of Patient Related Outcome Measures (PROMs) data
with the option of including linked Hospital Episode Statistics (HES) data. Please note that PROMs
data is only available for non-commercial purposes, such as academic research or in connection with
delivering services to the NHS.
PROMs data includes the EQ-5D visual analogue scale and index for all participating procedures. For
hip and knee replacements it includes the Oxford Hip Score and Oxford Knee Score, and for varicose
veins it includes the Aberdeen Varicose Veins Questionnaire score.
PROMs Consent
Due to the consent model as applied to PROMs data, customers who have existing HES extracts with
patient-identifiable information must declare that they will not attempt to link the PROMs data in order
to identify individual PROMs responses. Those customers who do wish to link PROMs to identifiable
HES data must secure specific approval under section 251 of the NHS Act 2006 in order to do so.
Declaration:
• I do not currently hold HES identifiable data.
• I hold HES identifiable data but do not wish to link this to PROMs data.
• I hold HES identifiable data and wish to link this to PROMs data. I understand that I
must obtain specific section 251 approval in order to do this.
Signature:
Date:
Published April 2013
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PROMs application form
PROMs Extract Specification Form
(Please either type or write in black ink, as this form will be photocopied)
Requested fields
This section allows you to indicate which fields you require (please select as appropriate):
PROMs data linked to HES inpatient extract only
All PROMs data
Procedures
Fields can be filtered by procedure type, if required. Please indicate which records you would like to
receive:
Default: All procedures
Hip replacements
Knee replacements
Groin hernia procedures
Varicose vein procedures
Additional filters (If you wish to any additional filters please use the space below)
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PROMs application form
PROMs data
Below is a list of the fields that you can request from the PROMs data set. For further details regarding
these fields please refer to the PROMS Data Dictionary available at
www.hscic.gov.uk/hesdatadictionary
General data
PROMs Serial Number
(PROMS_SERIAL_NO)
PROMs Procedure Code
(PROMS_PROC_CODE)
PROMs Procedure Group
(PROMS_PROC_GROUP)
Patient Death
(PATIENT_DEATH)
Complete
(COMPLETE)
Q1 Complete
(Q1_COMPLETE)
Q1 Completion Date
(Q1_COMPLETED_DATE)
Q1 Assisted
(Q1_ASSISTED)
Q1 Assisted by
(Q1_ASSISTED_BY)
Q1 Symptom Period
(Q1_SYMPTOM_PERIOD)
Q1 Previous Surgery
(Q1_PREVIOUS_SURGERY)
Sex of Patient
(GENDER)
Co-morbidities (12 fields showing whether the patient has indicated any co-morbidities eg diabetes
and cancer)
Q1 Living Arrangements
(Q1_LIVING_ARRANGEMENTS)
Q1 General Health
(Q1_GENERAL_HEALTH)
Q1 Disability
(Q1_DISABILITY)
Q1 Provider Code
(Q1_PROCODE)
Q2 Complete
(Q2_COMPLETE)
Q2 Completion Date
(Q2_COMPLETED_DATE)
Q2 Assisted
(Q2_ASSISTED)
Q2 Assisted by
(Q2_ASSISTED_BY)
Q2 Surgery Date
(Q2_SURGERY_DATE)
Q2 Surgery Complications (four fields showing whether the patient encountered any complications
post surgery, eg allergy and wound problems)
Q2 Readmitted
(Q2_READMITTED)
Q2 Further Surgery
(Q2_FURTHER_SURGERY)
Q2 Satisfaction
(Q2_SATISFACTION)
Q2 Success
(Q2_SUCCESS)
Q2 Living Arrangements
(Q2_LIVING_ARRANGEMENTS)
Q2 General Health
(Q2_GENERAL_HEALTH)
Q2 Disability
(Q2_DISABILITY)
Published April 2013
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PROMs application form
Scoring data
EQ-5D:
EQ-5D Index Change
EQ-5D Health Scale Change
Q1 EQ-5D Profile
Q1 EQ-5D Index
Q1 EQ-5D Health Scale
Q1 EQ-5D Responses
Q2 EQ-5D Profile
Q2 EQ-5D Index
Q2 EQ-5D Health Scale
Q2 EQ-5D Responses
Q1 EQ-5D Health Scale Complete
Q1 EQ-5D Profile Complete
Q2 EQ-5D Health Scale Complete
Q2 EQ-5D Profile Complete
(EQ5D_INDEX_CHANGE)
(EQ5D_SCALE_CHANGE)
(Q1_EQ5D_PROFILE)
(Q1_EQ5D_INDEX)
(Q1_EQ5D_HEALTH SCALE)
(Q2_EQ5D_PROFILE)
(Q2_EQ5D_INDEX)
(Q2_EQ5D_HEALTH_SCALE)
(Q1_EQ5D_SCALE_COMPLETE)
(Q1_EQ5D_PROFILE_COMPLETE)
(Q2_EQ5D_SCALE_COMPLETE)
(Q2_EQ5D_PROFILE_COMPLETE)
Procedure specific:
Procedure Specific Score Change
(SCORE_CHANGE)
Q1 Score
(HR_Q1_SCORE, KR_Q1_SCORE, GH_Q1_SCORE, VV_Q1_SCORE)
Q1 All Condition Specific Responses
Q1 Score Complete
(HR_Q1_SCORE_COMPLETE KR_Q1_SCORE_COMPLETE
VV_Q1_SCORE_COMPLETE)
Q2 Score
(HR_Q2_SCORE, KR_Q2_SCORE, GH_Q2_SCORE, VV_Q2_SCORE)
Q2 All Condition Specific Responses
Q2 Score Complete
(HR_Q2_SCORE_COMPLETE KR_Q2_SCORE_COMPLETE
VV Q1 Total Score
VV Q1 Max Score
VV Q2 Total Score
VV Q2 Max Score
VV_Q2_SCORE_COMPLETE)
(VV_Q1_TOTAL_SCORE) – available for varicose veins only
(VV_Q1_MAX_SCORE) – available for varicose veins only
(VV_Q2_TOTAL_SCORE) – available for varicose veins only
(VV_Q2_MAX_SCORE) – available for varicose veins only
Note: There is no condition-specific data for groin hernia procedures
Published April 2013
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PROMs application form
Metadata
A number of additional fields exist within the data set that provide details relating to the form and
scoring versions. For a full list of these fields please refer to Annex 1.
By default, these fields will not be provided. Please indicate here if you require these fields:
Metadata required
Field details (If you wish to provide any further instructions relating to the fields you require please
use the space below)
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PROMs application form
Annex 1: metadata field list
Please refer to the PROMs Data Dictionary available at www.hscic.gov.uk/hesdatadictionary for further
information regarding the below fields:
1. Status Date
(STATUS_DATE)
2. Modified Date
(MODIFIED_DATE)
3. EQ-5D Version
(EQ5D_VERSION)
4. Q1 Score Complete
(Q1_SCORE_COMPLETE)
1. Q1 Language
(Q1_LANGUAGE)
2. Q1 Scan Date
(Q1_SCAN_DATE)
3. Q1 EQ-5D Version
(Q1_EQ5D_VERSION)
4. Q2 Score Complete
(Q2_SCORE_COMPLETE)
5. Q2 Form Version
(Q2_FORM_VERSION)
6. Q2 Language
(Q2_LANGUAGE)
7. Q2 Scan Date
(Q2_SCAN_DATE)
8. Q2 EQ-5D Version
(Q2_EQ5D_VERSION)
9. Status
(STATUS)
Published April 2013
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PROMs application form
Acknowledgements
Any and all copyrights in the EQ-5D questions, their order, layout and images vest in the EuroQol
Group. The EuroQol Group reserves all rights. © 1992 EuroQol Group. EQ-5D™ is a trademark of the
EuroQol Group [http://www.euroqol.org].
Any and all copyrights in the Oxford Hip Score and Oxford Knee Score questions, their order and
layout vest in Isis Innovation Limited. Isis Innovation Limited reserves all rights. © 1996 Isis Innovation
[http://www.isis-innovation.com/licensing/healthoutcomes/oxford_hip_and_knee.html].
Except where expressly stated to the contrary, the Department of Health PROMs questionnaires are
protected by Crown copyright. © Crown copyright 2008.
For more details of the terms and conditions of use of the Department of Health PROMs
questionnaires, see the Department of Health website
[http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_0
91815].
Published April 2013
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