title: Influence of quality of care and individual patient characteristics on quality of life and return to work in survivors of the acute respiratory distress syndrome: protocol for a prospective, observational, multi-centre patient cohort study (DACAPO).
abstract: BACKGROUND
  Health-related quality of life (HRQoL) and return to work are important outcomes in critical care medicine, reaching beyond mortality. Little is known on factors predictive of HRQoL and return to work in critical illness, including the acute respiratory distress syndrome (ARDS), and no evidence exists on the role of quality of care (QoC) for outcomes in survivors of ARDS. It is the aim of the DACAPO study ("Surviving ARDS: the influence of QoC and individual patient characteristics on quality of life") to investigate the role of QoC and individual patient characteristics on quality of life and return to work.
  
  
  METHODS
  A prospective, observational, multi-centre patient cohort study will be performed in Germany, using hospitals from the "ARDS Network Germany" as the main recruiting centres. It is envisaged to recruit 2400 patients into the DACAPO study and to analyse a study population of 1500 survivors. They will be followed up until 12 months after discharge from hospital. QoC will be assessed as process quality, structural quality and volume at the institutional level. The main outcomes (HRQoL and return to work) will be assessed by self-report questionnaires. Further data collection includes general medical and ARDS-related characteristics of patients as well as sociodemographic and psycho-social parameters. Multilevel hierarchical modelling will be performed to analyse the effects of QoC and individual patient characteristics on outcomes, taking the cluster structure of the data into account.
  
  
  CONCLUSIONS
  By obtaining comprehensive data at patient and hospital level using a prospective multi-centre design, the DACAPO-study is the first study investigating the influence of QoC on individual outcomes of ARDS survivors.
authors.affiliation: Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany. susanne.brandstetter@ukr.de.
authors.forename: Susanne
authors.initials: S
authors.lastname: Brandstetter
authors.affiliation: Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany. frank.dodoo-schittko@ukr.de.
authors.forename: Frank
authors.initials: F
authors.lastname: Dodoo-Schittko
authors.affiliation: Department of Anaesthesiology, Operative Intensive Care, Regensburg University Hospital, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany. sebastian.blecha@ukr.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Blecha
authors.affiliation: Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany. philipp.seboek@ukr.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Sebök
authors.affiliation: Department of Anaesthesiology, Operative Intensive Care, Regensburg University Hospital, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany. kathrin.thomann-hackner@ukr.de.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Thomann-Hackner
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Charité - University Medicine Berlin, Augustenburger-Platz 1, 13353, Berlin, Germany. mquintel@gwdg.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Quintel
authors.affiliation: Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Medicine, Robert-Koch-Strasse 40, 37075, Göttingen, Germany. steffen.weber-carstens@charite.de.
authors.forename: Steffen
authors.initials: S
authors.lastname: Weber-Carstens
authors.affiliation: Department of Anaesthesiology, Operative Intensive Care, Regensburg University Hospital, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany. thomas.bein@ukr.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bein
authors.affiliation: Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany. christian.apfelbacher@klinik.uni-regensburg.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Apfelbacher
mesh_terms: D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005858:Germany; D006801:Humans; D007857:Leadership; D008297:Male; D011446:Prospective Studies; D011787:Quality of Health Care; D011788:Quality of Life; D012128:Respiratory Distress Syndrome / Q000188:drug therapy; D062707:Return to Work; D011795:Surveys and Questionnaires