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m&28(_1Pb. C3.,س}"有ng Does the appearance of your varicose veins cause you concern? s During the last two weeks, have your varicose veins interfered with your work/housework or other daily activities? e Left leg (front): requests the patient to illustrate the number of visible varicose veins in each legj Left leg (back): which requests the patient to illustrate the number of visible varicose veins in each legb Left leg: In the last two weeks, for how many days did your varicose veins cause you pain or ache?K Left leg: In the last two weeks have you worn support tights or stockings? b Left leg: In the last two weeks, have you had any itching in association with your varicose veins?} Left leg:Do you have purple discolouration caused by tiny blood vessles in the skin, in association with your varicose veins?C Left leg:Do you have any rash or eczema in the area of your ankle? F Left leg:Do you have a skin ulcer associated with your varicose veins?l Right leg (front): which requests the patient to illustrate the number of visible varicose veins in each legk Right leg (back): which requests the patient to illustrate the num< ber of visible varicose veins in each legb Right leg:In the last two weeks, for how many days did your varicose veins cause you pain or ache?L Right leg: In the last two weeks have you worn support tights or stockings? c Right leg: In the last two weeks, have you had any itching in association with your varicose veins?~ Right leg:Do you have purple discolouration caused by tiny blood vessles in the skin, in association with your varicose veins?D Right leg:Do you have any rash or eczema in the area of your ankle? H Right leg: Do you have a skin ulcer associated with your varicose veins? The predicted EQ-5D score based on the patient's casemix. Predicted scores are used in the calculation of the adjusted scores at organisation level The predicted EQ-VAS score based on the patient's casemix. Predicted scores are used in the calculation of the adjusted scores at organisation level The predicted Oxford Hip score based on the patient's casemix. Predicted scores are used in the calculation of the adjusted scores at organisation level The predicted Oxford Knee score based on the patient's casemix. Predicted scores are used in the calculation of the adjusted scores at organisation level The predicted Aberdeen VV Questionnaire score based on the patient's casemix. Predicted scores are used in the calculation of the adjusted scores at organisation level Possible Values B Groin Hernia | Hip Replacement | Knee Replacement | Varicose Veins| 1 = I have no problems in walking about | 2 = I have some problems in walking about | 3 = I am confined to bed | 9 = Missing 1 = I have no problems with self-care | 2 = I have some problems washing or dressing myself | 3 = I am unable to wash or dress myself | 9 = Missing 1 = I have no problems with performing my usual activities | 2 = I have some problems with performing my usual activities | 3 = I am unable to perform my usual activities | 9 = Missing 1 = I have no pain or discomfort | 2 = I have moderate pain or discomfort | 3 = I have extreme pain or discomfort | 9 = Missing 1 = I am not anxious or depressed | 2 = I am moderately anxious or depressed | 3 = I am extremely anxious or depressed | 9 = Missing1 0-100 = patients rated well-being | 999 = Missingo 1= None at all | 2 = Between 1 and 5 days | 3 = Between 6 and 10 days | 4 = For more than 10 days | 9 = Missings 1 = None at all | 2 = Slight ankle swelling | 3 = Moderate ankle swelling | 4 = Severe ankle swelling | 9 = Missing 1 = No | 2 = Yes, their appearance causes me slight concern | 3= Yes, their appearance causes me moderate concern | 4= Yes, their appearance causes me a great deal of concern | 9= Missing@ 1 = No | 2 = Occasionally | 3 = Often | 4 = Always | 9 = Missing 1 = No | 2 = I have been able to work but my work has suffered to some extent | 3 = I have been able to work but my work has suffered to a moderate extent | 4 = My veins have prevented me from working one day or more | 9 = Missing 1 = No | 2 = Yes, my enjoyment has suffered to a slight extent | 3 = Yes, my enjoyment has suffered to a moderate extent | 4 = My veins have prevented me from taking part in any leisure activities | 9 = Missing 1 = No | 2 = Yes, those I bought myself without a doctor's prescription | 3 = Yes, those my doctor prescribed for me which I wear occasionally | 4 = Yes, those my doctor prescribed for me which I wear every day | 9 Missing~ 1 = No | 2 = Yes, but only above the knee | 3 = Yes, but only below the knee | 4 = Both above and below the knee | 9 = Missing 1 = No | 2 = Yes | 9 = Missing 1 = No | 2 = Yes, but it does not require any treatment from a doctor or district nurse | 3 = Yes, and it requires treatment from my doctor or district nurse | 9 = Missing 1 = No | 2 = I have been able to work but my work has suffered to some extent | 3 = I have been ablet o work but my work has suffered to a moderate extent | 4 = My veins have prevented me from working one day or more | 9 = MissingE INTERPRETING THE PATIENT LEVEL DATA - A GUIDE TO THE PROMS QUESTIONS.* Rates the patients self-perceived mobility@ Rates the patients self-perceived ability to care for themselvesE Rates the patients self-perceived ability to perform usual activities1 Rates the patients self-perceived pain/discomfort= Rates the patients self-perceived level of Anxiety/DepressionU Copyright 2012, The Health and Social Care Information Centre. All Rights Reserved.M 4 = None | 3 = Very Mild | 2 = Mild | 1 = Moderate | 0 = Severe | 9 = Missing` 4 = No days | 3 = Only 1 or 2 days | 2 = Some days | 1 = Most days | 0 = Every day | 9 = Missingj 4 = No nights | 3 = Only 1 or 2 nights | 2 = Some nights | 1 = Most nights | 0 = Every night | 9 = Missing 4 = No trouble at all | 3 = Very little trouble | 2 = Moderate trouble | 1 = Extreme difficulty | 0 = Impossible to do | 9 = Missing 4 = Yes, easily | 3 = With little difficulty | 2 = With moderate difficulty | 1 = With extreme difficulty | 0 = No, impossible | 9 = Missing 4 = No pain/more than 30 minutes | 3 = 16-30 minutes | 2 = 5-15 minutes | 1 = Around the house only | 0 = Not at all - pain severe on walking | 9 = Missing 4 = Rarely/Never | 3 = Sometimes or just at first | 2 = Often, not just at first | 1 = Most of the time | 0 = All of the time | 9 = Missingx 4 = not at all painful | 3 = Slightly painful | 2 = Moderately painful | 1 = Very painful | 0 = Unbearable | 9 = Missing\ 4 = Not at all | 3 = A little bit | 2 = Moderately | 1 = Greatly | 0 = Totally | 9 = Missing * 2+ q + =, | , D- - C. . 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