Smart Technology Facilitated Patient-centered Care for Patients With Pulmonary Thromboembolism

VTE events will be documented at the 3, 6, 12, and 24-month follow-up after discharge. VTE events are categorized into two groups: recurrent VTE and newly diagnosed DVT.

Recurrent VTE is defined as the appearance of new evidence of VTE after acute VTE has been treated in the acute phase (2 weeks) with significant clinical improvement in signs and symptoms. According to the time of VTE recurrence, it is further categorized into early VTE recurrence (within 3 months after the last VTE occurrence) and late VTE recurrence (more than 3 months after the last VTE occurrence).

DVT that occurred for the first time after discharge during the study period is classified as newly diagnosed DVT.

The diagnosis of CTEPH will be documented at the 3, 6, 12, and 24-month follow-up.

The diagnosis of CTEPD will be documented at the 3, 6, 12, and 24-month follow-up after discharge.

The diagnosis of PPES will be documented at the 3, 6, 12, and 24-month follow-up after discharge

The major bleeding events as defined by the International Society on Thrombosis and Hemostasis (ISTH) will be documented at the 3, 6, 12, and 24-month follow-up after discharge.

Rehospitalization due to VTE recurrence, progression, or complications related to VTE treatment will be documented during the follow-up.

Death will be documented during the follow-up. It is categorized into all-cause death and PTE-related death. All-cause death is defined as death that occurs during the study period, regardless of cause. PTE-related death is defined as death that is unequivocally due to PTE.

PROs will be documented during the 3, 6, 12, and 24-month follow-up after discharge.

PROs refer to information directly conveyed by patients themselves concerning their health status, symptoms, functional capacity, or adverse events related to treatment, without the need for interpretation or mediation by clinicians or other third parties.

Generic, non-disease-specific health-related quality of life (QoL) is assessed using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire and its corresponding visual analogue scale at 6, 12, and 24 months after discharge. Briefly, the EQ-5D-5L generates an overall index that ranges from 0 (lowest generic QoL) to 1 (highest generic QoL) and is calculated based on country-specific reference value sets. The EQ-5D-5L health index was calculated with the value set for China. The EuroQol visual analogue scale ranges from 0 to 100, with higher scores indicating better health.

Costs of healthcare staff training (training duration × hourly wage), including training on standardized management of pulmonary embolism and the use of mVTEA; costs associated with post-discharge patient management by healthcare personnel (such as follow-up management, rehabilitation management, health counseling, and comorbidity management), calculated as (consultation time/re-hospitalization time × hourly wage); and development costs for mobile technology and intelligent algorithms.

Treatment costs for VTE-related patients within 12 months post-discharge: These include registration fees, diagnostic costs, and treatment expenses incurred during visits to community clinics, hospital emergency departments, or specialist outpatient clinics due to changes in PTE condition (such as VTE recurrence, newly diagnosed DVT, bleeding, CTEPH, CTEPD, or PPES). They also encompass diagnostic and treatment expenses during hospital admissions in community or specialist settings due to changes in PTE condition. Additionally, costs arising from routine VTE follow-ups (without any changes in VTE-related conditions) at community clinics, hospital emergency departments, or specialist outpatient clinics are included.

Treatment costs for non-VTE-related patients within 12 months post-discharge: These comprise registration fees, diagnostic costs, and treatment expenses associated with visits to community clinics, hospital emergency departments, or specialist outpatient clinics for non-VTE-related conditions, as well as diagnostic and treatment expenses during hospital admissions in community or specialist settings for non-VTE-related diseases.

Adherence would be assessed at months 3, 6, and 12 after discharge (defined as: the number of patients taking anticoagulants as prescribed/total number of patients at follow-up time point × 100%).

Clinical cure rate of PTE (defined as the numbers of patients without VTE recurrence, newly diagnosed DVT, bleeding, CTEPH, CTEPD, PPES, or all-cause mortality / total number of patients at the follow-up time point × 100% ); VTE (PTE/DVT) recurrence rate; incidence rate of newly diagnosed DVT; bleeding incidence rate; major bleeding incidence rate; non-major bleeding incidence rate; CTEPH incidence rate; CTEPD incidence rate; PPES incidence rate; all-cause mortality rate; PTE-related mortality rate would be collected.

Quality-Adjusted Life Year(QALY) with EQ-5D-5L questionnaire would be investigated at 3, 6, and 12 months post-discharge and when the occurrence of VTE-related adverse events, including newly diagnosed DVT, bleeding, CTEPH, CTEPD, PPES, or all-cause mortality.