Consistent with our findings, Fadini et al also did not find any relationship between EPC levels and the microvascular complications of diabetes. This apparently disparate result between the coronary epicardial and microcirculation may be due to the different pathogenic mechanisms leading to the development of epicardial and microvascular disease. Given the small number of patients in this study, it is possible that a significant association between OEC levels and CFR could have been missed. Likewise, the relationship between OEC levels and function and the microvasculature remains to be clarified by a larger study. Despite compelling evidence that patients at the end of life and their informal carers highly value the ability to finalise affairs at the end of life, effectiveness studies rarely include or explicitly measure this domain. It is important to ensure that the new tool is psychometrically sound. Consequently scale reliability and validity need to be assessed commensurate with the requirements of a single-item scale. The instrument should measure the concept it was designed to capture ; have theoretically meaningful relationships with other measures ; and reproduce the same results in similar circumstances. Additionally, the measurement tool should pick up differences in actual observed outcomes when present and should be appropriately designed for the target population. The EOLPRO was developed to be used in addition to other palliative care QOL instruments to capture changes in the ability to manage one’s affairs in preparation for death for health services research. Very few QOL questionnaires consider constructs capturing this patient-valued domain. Within this context, the preliminary findings for content and construct validity, test-retest reliability, responsiveness and feasibility presented in this study are GSK1363089 encouraging. The thematic analysis, and member and respondent verification suggest that the EOLPRO adequately captures patients’ ability to complete physical tasks and finalise practical matters in preparation for death. Qualitative palliative care studies evaluating factors that are important to measure in the last weeks of life collectively suggest that ‘preparation’ should include: financial matters; funeral arrangements; writing a will; resolution of conflicts; emotional matters; completion of goodbyes; and legal arrangements. Whilst virtually all of these items were mentioned during the cognitive interviews it is unclear whether the EOLPRO provokes thoughts of emotional and unresolved relationship issues or closure before death. Participants may have been unwilling to consider such painful aspects or to discuss personal and sensitive aspects of preparation for death. Such matters may not be relevant for individuals. Alternatively, the term ‘personal affairs’ may not resonate with participants who have not yet needed help with these aspects.