***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Endovenous laser ablation ( EVLA ) and radiofrequency ablation ( RFA ) are both associated with excellent technical , clinical and patient‐reported outcomes for the treatment of varicose veins . The aim of this study was to compare the techniques in a r and omized clinical trial Quality of life may be considerably reduced in patients who are suffering from chronic lower limb venous insufficiency , although existing generic quality of life instruments ( NHP , SF-36 or SIP ) can not completely identify their specific complaints . The Chronic Venous Insufficiency Question naire ( CIVIQ ) has been developed by iterative process . First , a pilot group of 20 patients was used to identify a number of important features of quality of life affected by venous insufficiency , other than physical symptoms of discomfort . A second study involving 2,001 subjects was used to reduce the number of items . Subjects were asked to score both the severity of their problems and the importance they attributed to each problem on a 5-point Likert scale . The importance items found in patients with venous insufficiency were subjected to factorial analyses ( PCA , PAF ) . The final version is a 20-item self-administered question naire which explores four dimensions : psychological , physical and social functioning and pain . Internal consistency of the question naire was vali date d for each dimension ( Cronbach 's alpha > 0.820 for three out of four factors ) . Reproducibility was confirmed in a 60 patient test-retest study . Pearson 's correlation coefficients for both the four dimension subscales and for the global score at 2-week intervals were greater than 0.940 . Finally , the question naire was tested in a r and omized clinical trial of 934 patients in order to assess responsiveness and the convergent validity of the instrument , together with the patient 's own quality of life . This study demonstrated that convergence was valid : Pearson 's correlation coefficients between clinical score differences and quality of life score differences were small ( from 0.199–0.564 ) but were statistically different from 0 ( p<0.001 ) . St and ardized response mean ( SRM ) and effect size ( ES ) were calculated to assess sensitivity to change . SRM and ES both demonstrated considerble responsiveness to change ( > 0.80 ) . Reliability , face , content , construct validity and responsiveness were also determined for this specific quality of life question naire relating to venous insufficiency . Results suggest that this question naire may be used with confidence to assess quality of life in clinical trials on chronic venous insufficiency OBJECTIVES This study aims to compare the efficacy and side effects of foam sclerotherapy of the saphenous veins with or without post-treatment compression using graduated elastic stockings . DESIGN This is a prospect i ve open r and omised controlled trial conducted in two centres . PATIENTS AND METHODS Sixty patients with incompetent great ( GSV ) or small saphenous veins ( SSV ) underwent ultrasound-guided foam sclerotherapy .  R and omisation was conducted immediately after sclerotherapy to two parallel groups , one ( CG ) with compression stockings ( 15 - 20 mmHg worn during the day , for 3 weeks ) and the other ( WCG ) without compression .  Efficacy of sclerotherapy and all of the side effects were assessed , including side effects in the treated region . On days 14 and 28 , clinical and duplex ultrasound ( DUS ) assessment s were performed by independent experts . Patients also completed quality of life ( QOL ) , symptom question naires and provided satisfaction scores .  RESULTS Five men and 55 women ranging in age from 32 to 78 ( mean 57 years ) years were included : 29 in the WCG and 31 in the CG group . On day 28 , abolition of venous reflux and occlusion of the vein was obtained in 100 % of the cases in both groups . The length of the occluded vein was the same in both groups ( mean 36 cm for the GSV and 30 cm for the SSV ) as was the mean diameter of the occluded vein ( 5 mm ) . Symptoms and QOL question naires showed equivalent improvement in both groups on day 28 compared to pre-treatment assessment s. Side effects were few with no statistical difference between the two groups . Patient satisfaction scores were high in both groups for the outcome of sclerotherapy results , and good or very good for compression in 50 % of the CG cases . CONCLUSION We found no difference between compression and control groups when comparing efficacy , side effects , satisfaction scores , symptoms and QOL . Further studies are required to establish the role of compression in sclerotherapy and to evaluate other compression strategies BACKGROUND / OBJECTIVES We prospect ively measured change in quality of life ( QOL ) during the 2 years after a diagnosis of deep vein thrombosis ( DVT ) and evaluated determinants of QOL , including development of the post-thrombotic syndrome ( PTS ) . PATIENTS / METHODS Consecutive patients with acute DVT were recruited from 2001 to 2004 at eight hospitals in Canada . At study visits at baseline , and 1 , 4 , 8 , 12 and 24 months , clinical data were collected , st and ardized PTS assessment s were performed , and QOL question naires were self-completed . Generic QOL was measured using the Short-Form Health Survey-36 ( SF-36 ) question naire . Venous disease-specific QOL was measured using the Venous Insufficiency Epidemiological and Economic Study (VEINES)-QOL/Sym question naire . The change in QOL scores over a 2-year follow-up was assessed . The influence of PTS and other characteristics on QOL at 2 years was evaluated using multivariable regression analyses . RESULTS Among the 387 patients recruited , the average age was 56 years , two-thirds were out patients , and 60 % had proximal DVT . The cumulative incidence of PTS was 47 % . On average , QOL scores improved during follow-up . However , patients who developed PTS had lower scores at all visits and significantly less improvement in QOL over time ( P-values for PTS*time interaction were 0.001 , 0.012 , 0.014 and 0.006 for PCS , MCS , VEINES-QOL and VEINES-Sym ) . Multivariable regression analyses showed that PTS ( P < 0.0001 ) , age ( P = 0.0009 ) , proximal DVT ( P = 0.01 ) and inpatient status ( P = 0.04 ) independently predicted 2-year SF-36 PCS scores . PTS alone independently predicted 2-year VEINES-QOL ( P < 0.0001 ) and VEINES-Sym ( P < 0.0001 ) scores . CONCLUSIONS Development of PTS is the principal determinant of health-related QOL 2 years after DVT . Our study provides prognostic information on patient-reported outcomes after DVT and emphasizes the need for effective prevention and treatment of the PTS BACKGROUND Great saphenous vein ( GSV ) incompetence is the most common cause of superficial venous insufficiency .  Radiofrequency catheter ablation ( RFA ) is superior to conventional ligation and stripping , and endovenous laser treatment ( EVL ) has emerged as an effective alternative to RFA . This r and omized study evaluated RFA and EVL for superficial venous insufficiency due to GSV incompetence and compared early and 1-year results . METHODS Between June 2006 and May 2008 , patients with symptomatic primary venous insufficiency due to GSV incompetence were r and omized to RFA or EVL .  Patients with bilateral disease were r and omized for treatment of the first leg and received the alternative method on the other . Pretreatment examination included a leg assessment using the Venous Clinical Severity Score ( VCSS ) and CEAP classification . Patients completed the Chronic Venous Insufficiency Question naire 2 ( CIVIQ2 ) . RFA was performed with the ClosurePlus system ( VNUS Medical Technologies , Sunnyvale , Calif ) . EVL was performed with the EVLT system ( AngioDynamics Inc , Queensbury , NY ) . Early ( 1-week and 1-month ) postoperative results of pain , bruising , erythema , and hematoma were recorded . Duplex ultrasound ( DU ) imaging was used at 1 week and 1 year to evaluate vein status . VCSS scores and CEAP clinical class were recorded at each postoperative visit , and quality of life ( QOL ) using CIVIQ2 was assessed at 1 month and 1 year . RESULTS The study enrolled 118 patients ( 141 limbs ) : 46 ( 39 % ) were r and omized to RFA and 48 ( 40 % ) to EVL , and 24 ( 20 % ) had bilateral GSV incompetence . At 1 week , one patient in the RFA group had an open GSV and was deemed a failure . More bruising occurred in the EVL group ( P = .01 ) at 1 week , but at 1 month , there was no difference in bruising between groups . At 1 year , DU imaging showed evidence of recanalization with reflux in 11 RFA and 2 EVL patients ( P = .002 ) . The mean VCSS score change from baseline to 1 week postprocedure was higher for RFA than EVL ( P = .002 ) , but there was no difference between groups at 1 month ( P = .07 ) and 1 year ( P = .9 ) . Overall QOL mean score improved over time for all patients ( P < .001 ) . CEAP clinical class scores of > or=3 were recorded in 21 RFA ( 44 % ) and 24 EVL patients ( 44 % ) pretreatment , but at 1-year , 9 RFA ( 19 % ) and 12 EVL patients ( 24 % ) had scores of > or=3 ( P < .001 ) . This represented a significant improvement in all patients compared with baseline . CONCLUSION Both methods of endovenous ablation effectively reduce symptoms of superficial venous insufficiency .  EVL is associated with greater bruising and discomfort in the perioperative period but may provide a more secure closure over the long-term than RFA Objectives To investigate whether additional catheter-directed thrombolysis ( CDT ) improves long-term quality of life ( QOL ) compared with st and ard treatment with anticoagulation and compression stockings alone in patients with proximal deep vein thrombosis ( DVT ) . Design Open-label r and omised controlled trial . Setting 19 Hospitals in the Norwegian southeastern health region . Participants Patients ( 18–75 years ) with a high proximal DVT , symptoms < 21 days and no increased risk of bleeding were eligible . 189 of 209 recruited patients completed 24 months of follow-up . Interventions Participants were r and omised to additional CDT with alteplase for 1–4 days or to st and ard treatment only with 6 months of anticoagulation and 24 months of compression stockings . Primary and secondary outcome measures Planned secondary outcome measures included QOL as assessed with the generic instrument EQ-5D and the disease-specific instrument VEINES-QOL/Sym . Primary outcome measure was post-thrombotic syndrome ( PTS ) after 24 months . Results After 24 months there were no differences in QOL between the additional CDT and st and ard treatment arms ; mean difference for the EQ-5D index was 0.04 ( 95 % CI −0.10 to 0.17 ) , for the VEINES-QOL score 0.2 ( 95 % CI −2.8 to 3.0 ) and for the VEINES-Sym score 0.5 ( 95 % CI −2.4 to 3.4 ; p values>0.37 ) . Independent of treatment arms , patients with PTS had poorer outcomes than patient without PTS ; mean difference for EQ-5D was 0.09 ( 95 % CI 0.03 to 0.15 ) , for VEINES-QOL score 8.6 ( 95 % CI 5.9 to 11.2 ) and for VEINES-Sym score 9.8 ( 95 % CI 7.3 to 12.3 ; p values<0.001 ) . Conclusions QOL did not differ between patients treated with additional CDT compared with st and ard treatment alone . Patients who developed PTS reported poorer QOL and more symptoms than patients without PTS . QOL should be included as an outcome measure in clinical studies on patients at risk of PTS . Trial registration AIM The early results of a r and omised clinical trial comparing local anaesthesia endovenous laser ablation ( EVLA ) with concurrent phlebectomies versus ultrasound-guided foam sclerotherapy ( UGFS )  into the great saphenous vein ( GSV ) revealed that laser was more expensive but the results on abolition of reflux were similar . The interim results at 15 month follow-up are reported . METHODS Evaluations included ultrasound , the venous clinical severity score ( VCSS ) , the Aberdeen varicose vein question naire ( AVVQ ) and the saphenous treatment score ( STS ) . The global absence of reflux defined technical success . Adjuvant sclerotherapy to areas of reflux was administered on patient choice . RESULTS Occlusion of the GSV was more effective with EVLA at 42/44 ( 95.5 % ) versus 31/46 ( 67.4 % ) for UGFS . However both techniques were equally effective at abolishing global venous reflux . The  number of legs ( N.=100 ) with total reflux 
    Output:
    
Among them , the ChronIc Venous Insufficiency Question naire ( CIVIQ ) , Aberdeen Varicose Vein Question naire ( AVVQ ) , and VEnous INsufficiency Epidemiological and Economic Study on Quality of Life  ( VEINES-QOL ) scales were the most highly used according to the literature , and CIVIQ and VEINES-QOL were the most extensively vali date d scales and had the longest iterative validation process .
This systematic review confirmed that CVDs have an important effect on QOL .
Two scales , CIVIQ and VEINES-QOL , emerged as being thoroughly vali date d instruments , although factorial stability was not demonstrated for the VEINES-QOL .