GAP-AVR
Research type
Research Study
Full title
Patients and cardiologists’ perceptions of gender disparities in the aortic valve replacement (AVR) pathway: An exploratory qualitative study of the barriers and enablers.
IRAS ID
349395
Contact name
Clare Appleby
Contact email
Sponsor organisation
Vox.Bio (a subdivsion of Cambridge Healthcare Research Limited)
Duration of Study in the UK
0 years, 5 months, 27 days
Research summary
Aortic stenosis (AS) is the valve disease most commonly requiring intervention in England. In the UK, the standard of care for treating AS is aortic valve replacement(AVR), either transcatheter (TAVI) or surgical (SAVR). AVR procedures relieve symptoms, increase life expectancy and improve quality of life. For patients with severe AS, the median survival without AVR is 50% at 2 years.
A large real-world analysis of Hospital Episode Statistics (HES) data for NHS England found that patients who are female (also black, Asian or those on a lower income) are significantly less likely to be offered AVR. Now that this gender disparity has been sighted, it’s important that further research is conducted to investigate the possible causes to ensure equitable access to this life-saving treatment.
For the study, we will recruit AS patients and referring cardiologists (those who refer patients for an AVR procedure) for one single qualitative structured interview (lasting up to 45 minutes) exploring physician referral patterns, aided by the completion of anonymised patient record forms (PRFs) and patients' experience of their pathway.
AS patients are eligible if they are aged 18 or above, have undergone an AVR procedure (TAVI or SAVR), and can describe their journey with aortic stenosis and the AVR procedure. Cardiologists are eligible if they refer severe AS patients for AVR procedures (either TAVI or SAVR) and work clinically in any of nine selected NHS England Trusts.
This is a multicentre study: Patients will be recruited from the pool of patients referred to two high-volume tertiary cardiothoracic centres (Liverpool Heart and Chest Hospital NHS FT and The Royal Wolverhampton NHS Trust). The referring cardiologist's opinions will be sought from those cardiologists referring to these two trusts. While they may practice in other Hospitals, they will also be recruited to these two Trusts.REC name
London - Queen Square Research Ethics Committee
REC reference
25/LO/0478
Date of REC Opinion
4 Sep 2025
REC opinion
Further Information Favourable Opinion