所有受邀参与的焦点小组成员对这一过程表示欢迎，许多人分享了他们个人护理经历与指南中建议的治疗方式存在的差异。特别是，在专科静脉评估的转诊过程中通?；岢鱿盅映伲」苷饪赡苁怯⒐椅郎值奶乩?。部分患者反映穿戴弹性压力袜的困难，焦点小组强调了在建议患者使用这种袜子时提供协助的重要性。

    此外，焦点小组成员认为关于浅静脉腔内消融的描述过于复杂，建议进行简化。在讨论中，有6名焦点小组成员提到他们接受了静脉腔内消融手术，强调了共同决策在治疗选择中的重要性，并表达了即使当地无法提供某些治疗方式，也希望能够探讨其他潜在的治疗方案。

    这些焦点小组的反馈被纳入指南的修订过程中，有助于进一步优化简明摘要的内容，确保其更贴近患者和公众的实际需求和理解水平。

☆6. The revision process and update of  guidelines. ☆ 

        The guide lines document underwent external review for critical evalu ation of the content and recommendations by members of the ESVS Guidelines Steering Committee, and by other indepen dent experts in the field. After each review round, the re viewers’general and detailed comments were compiled into one document. The manuscript was then revised according to the reviewers comments and all amendments were discussed and approved by all members of the GWC. In addition, a point to point reply to the reviewers was provided. After three re view and subsequent revision rounds, the final document was approved and submitted to the European Journal of Vascular and Endovascular Surgery on 10 November 2021. These guidelines will be updated in 2026, according to the ESVS policy to update all guidelines which are part of the core curriculum of the vascular surgeon every four years.

☆ 7. The patient perspective. ☆ 

       The importance of patient and public involvement in clinical guideline development is widely recognised and accepted. Patient engagement im proves validity, increases quality of decisions, and is encouraged by national and international groups.

       To improve accessibility and interpretability for patients and the public, a plain English summary has been produced for this guideline and subjected to a lay review process. Information for patients was drafted for each subchapter which was read and amended by a vascular nurse specialist and at least one lay person or patient.

       Lay summaries were evaluated by a patient focus group, consisting of eight patients in the United Kingdom National Health Service with a history of CVD (six patients with C2-C5 disease and two patients with C6 disease) and three lay members of the public without CVD. All members of the focus group had been sent the lay summaries prior to the meeting, which was held virtually because of COVID-19 restrictions. At the meeting, the background and rationale for the ESVS CVD guidelines were presented and focus group feedback was obtained for each section of the document, systematically. All members of the focus group welcomed the invitation to contribute to the process and many commented that their personal experiences of care had been very different to the treatments recommended in the guidelines. Specifically, referral for specialist venous assessment had often been very delayed, although this may be a specific reflection of the United Kingdom National Health Service.

       Several patients stated that they had tried compression garments but found them difficult to wear. The group felt it important to express that where compression is recom mended to patients, aids to help donning and removal of the stockings should be provided. The section describing superfi-cial venous ablation procedures was found to be complex by the patients and lay members of the focus group and was simplified accordingly. Six of the patients in the focus group had been treated with endovenous ablation procedures. The group emphasised the importance of shared decision making and stated that they would want to discuss potential treat ment options even if not locally available. Feedback from the focus group was used to amend the lay summaries.