<p> IMPROVE Trial ID Must be printed on Trust headed paper, with name and contact</p><p> details of the local Immediate Management of the Patient with Rupture:Principal Investigator Open Versus Endovascular repair England, Wales & Northern Ireland Ethics Ref No: 08/H0505/173</p><p><<Enter Date>></p><p>Dear <<Patient’s First Name>>,</p><p>I am writing to you about the IMPROVE research study that you very kindly agreed to take part in when you underwent repair for your ruptured aneurysm a few years ago. Regular updates about this study are posted on the trial website: www.improvetrial.org As part of this study, we are writing to ask you to fill in a final short questionnaire about your current health status.</p><p>When you have filled in the enclosed questionnaire please return it to us in the pre-paid envelope provided.</p><p>As a token of our appreciation for your assistance with the study, we enclose a £10 shopping voucher. This can be used at a number of different shops (as detailed on the voucher).</p><p>If you have any queries about the questions or would like to discuss this research further, please don’t hesitate to contact me <<Enter Name>> on <<Enter contact Telephone no.>></p><p>Thank you again for your help with this study.</p><p>Yours sincerely,</p><p><<Enter Name>> <<Enter Job Title>></p><p>Patient letter for additional EQ-5D: Version 1.0 28-Aug-2013 IMPROVE Trial ID </p><p>Immediate Management of the Patient with Rupture: Open Versus Endovascular repair</p><p>Health Questionnaire </p><p>The EQ-5D form must be completed in the 2.5 - 4 year time window following aneurysm repair.</p><p>Date of questionnaire completion: dd/mm/yy </p><p>IMPROVE Trial Contacts:</p><p>Trial Chief Investigator: Professor Janet T Powell Trial Manager: Dr Pinar Ulug E-mail: [email protected] E-mail: [email protected] Tel: 020 3311 7312 Tel: 020 3311 7307 Fax: 020 3311 7330 Fax: 020 3311 7318 </p><p>Vascular Surgery Research Group, Imperial College at Charing Cross Hospital St. Dunstan’s Road, London W6 8RP IMPROVE Trial ID </p><p>By placing a tick in one box in each group below, please indicate which statements best describe your own health state today.</p><p>Mobility I have no problems in walking about  I have some problems in walking about  I am confined to bed </p><p>Self-Care I have no problems with self-care  I have some problems washing or dressing myself  I am unable to wash or dress myself </p><p>Usual Activities (e.g. work, study, housework, family or leisure activities) I have no problems with performing my usual activities  I have some problems with performing my usual activities  I am unable to perform my usual activities </p><p>Pain/Discomfort I have no pain or discomfort  I have moderate pain or discomfort  I have extreme pain or discomfort </p><p>Anxiety/Depression I am not anxious or depressed  I am moderately anxious or depressed  I am extremely anxious or depressed </p><p>UK (English) © 1990 EuroQol Group EQ-5D™ is a trade mark of the EuroQol Group Best </p><p>IMPROVE Trial ID imaginable health state</p><p>100 To help people say how good or bad a health state is, we have drawn a scale (rather like a thermometer) on which the best state you can imagine is marked 100 and the worst state you can imagine is marked 0. 9 0</p><p>We would like you to indicate on this scale how good or bad your own health is today, in your opinion. Please do this by drawing a line from the box below to 8 0 whichever point on the scale indicates how good or bad your health state is today. 7 0</p><p>6 0</p><p>Your own health state 5 0 today</p><p>4 0</p><p>3 0</p><p>2 0</p><p>1 0</p><p>0 Worst imaginable health state</p><p>UK (English) © 1990 EuroQol Group EQ-5D™ is a trade mark of the EuroQol Group</p>