Follow Up Interview

I am a survivor and I received a second letter or a consent form, why?

All survivors will be invited to participate in an interview over the phone in the months following your hospital discharge. Our interview will ask a series of questions to measure your quality of life and neurological status after your cardiac arrest. For a copy of the letter that you received from us, please click on the link below:

Survivor Notification Letter

We think that the interview will take about 15 minutes to complete. If you wish to review these questionnaires beforehand, you can find copies of the questionnaires in the section below. During the interview, you can decide not to answer the questions or end the interview at any time if you feel uncomfortable.

If you have received this letter in error, our sincere condolences for your loss and our apologies for any pain or inconvenience the letter may have caused. If at any time you find yourself having any questions or concerns about the EpiDOSE Trial, please do not hesitate to contact us at your convenience at epidose@unityhealth.to

Interview Questionnaries

In order to gain a better understanding of long-term outcomes after receiving treatment with different total doses of epinephrine, we hope conduct a short telephone interview with out-of-hospital cardiac arrest survivors that are in enrolled in EpiDOSE. We are looking to obtain information about your current emotional, physical and neurological status post cardiac arrest.

Modified Rankin Scale

The Modified Rankin Scale asks questions related to the abilities/disabilities of patients who have suffered a cardiac arrest. This will help us understand the effects a cardiac arrest may have on a patient’s neurological state.

Modified Rankin Scale Questionnaire

Health Utility Index

The Health Utility Index asks questions related to the senses, as well as certain physical abilities. It is designed to ask a minimum number of questions in order to understand the state of health for a patient.

Health Utility Index Questionnaire

The Hospital Anxiety and Depression Scale

The Hospital Anxiety and Depression Scale asks questions related to your emotional state. It will help us understand how you feel emotionally, after the cardiac arrest event.

Hospital Anxiety and Depression Scale Questionnaire