Paul S Chan1, Philip G Jones2, Suzanne A Arnold2, John A Spertus2. 1. From the Department of Internal Medicine, Mid-America Heart Institute, Kansas City, MO (P.S.C., P.G.J., S.A.A., J.A.S.); and the Department of Internal Medicine, University of Missouri, Kansas City (P.S.C., S.A.A., J.A.S.). pchan@saint-lukes.org. 2. From the Department of Internal Medicine, Mid-America Heart Institute, Kansas City, MO (P.S.C., P.G.J., S.A.A., J.A.S.); and the Department of Internal Medicine, University of Missouri, Kansas City (P.S.C., S.A.A., J.A.S.).
Abstract
BACKGROUND: Clinical trials and national performance measures increasingly mandate reporting patients' perspectives of their health status: their symptoms, function, and quality of life. Although the Seattle Angina Questionnaire (SAQ) is a validated disease-specific health status instrument for coronary artery disease (CAD) with high test-retest reliability, predictive power, and responsiveness, its use in routine clinical practice has been limited, in part, by its length (19 items). METHODS AND RESULTS: Using data from 10 408 patients with CAD from 5 multicenter registries, we derived and validated a shortened version of the SAQ (SAQ-7) among patients presenting with stable CAD, undergoing percutaneous coronary intervention, and after acute myocardial infarction. We examined the psychometric properties of the SAQ-7 as compared with the full SAQ. Seven items from the Physical Limitation, Angina Frequency, and Quality of Life domains were identified for the SAQ-7, with high levels of concordance (0.88-1.00) with each original SAQ domain. The SAQ-7 demonstrated good construct validity (compared with Canadian Cardiovascular Society class for angina), with a correlation of 0.62 and 0.38 for patients with stable CAD and undergoing percutaneous coronary intervention, respectively. It was highly reproducible in patients with stable CAD (intraclass correlation, ≥0.78) and exhibited excellent responsiveness in patients after percutaneous coronary intervention (≥18 points in each SAQ domain). Finally, the SAQ-7 was predictive of 1-year mortality and readmission. CONCLUSIONS: To increase the feasibility of measuring patient-reported outcomes in patients with CAD, we developed and validated a shortened 7-item SAQ instrument for use in clinical trials and routine care.
BACKGROUND: Clinical trials and national performance measures increasingly mandate reporting patients' perspectives of their health status: their symptoms, function, and quality of life. Although the Seattle Angina Questionnaire (SAQ) is a validated disease-specific health status instrument for coronary artery disease (CAD) with high test-retest reliability, predictive power, and responsiveness, its use in routine clinical practice has been limited, in part, by its length (19 items). METHODS AND RESULTS: Using data from 10 408 patients with CAD from 5 multicenter registries, we derived and validated a shortened version of the SAQ (SAQ-7) among patients presenting with stable CAD, undergoing percutaneous coronary intervention, and after acute myocardial infarction. We examined the psychometric properties of the SAQ-7 as compared with the full SAQ. Seven items from the Physical Limitation, Angina Frequency, and Quality of Life domains were identified for the SAQ-7, with high levels of concordance (0.88-1.00) with each original SAQ domain. The SAQ-7 demonstrated good construct validity (compared with Canadian Cardiovascular Society class for angina), with a correlation of 0.62 and 0.38 for patients with stable CAD and undergoing percutaneous coronary intervention, respectively. It was highly reproducible in patients with stable CAD (intraclass correlation, ≥0.78) and exhibited excellent responsiveness in patients after percutaneous coronary intervention (≥18 points in each SAQ domain). Finally, the SAQ-7 was predictive of 1-year mortality and readmission. CONCLUSIONS: To increase the feasibility of measuring patient-reported outcomes in patients with CAD, we developed and validated a shortened 7-item SAQ instrument for use in clinical trials and routine care.
Authors: Darcy Green Conaway; John House; Kathleen Bandt; Lauren Hayden; A Michael Borkon; John A Spertus Journal: J Am Coll Cardiol Date: 2003-10-15 Impact factor: 24.094
Authors: A Michael Borkon; Gregory F Muehlebach; John House; Steven P Marso; John A Spertus Journal: Ann Thorac Surg Date: 2002-11 Impact factor: 4.330
Authors: John S Rumsfeld; David J Magid; Mary E Plomondon; Jerome Sacks; William Henderson; Mark Hlatky; Gulshan Sethi; Douglass A Morrison Journal: J Am Coll Cardiol Date: 2003-05-21 Impact factor: 24.094
Authors: Daniel B Kramer; Daniel D Matlock; Alfred E Buxton; Nathan E Goldstein; Carol Goodwin; Ariel R Green; James N Kirkpatrick; Christopher Knoepke; Rachel Lampert; Paul S Mueller; Matthew R Reynolds; John A Spertus; Lynne W Stevenson; Susan L Mitchell Journal: Circ Cardiovasc Qual Outcomes Date: 2015-06-02
Authors: Jesse Xiaolong Yang; Margaret J Stevenson; Linda Valsdottir; Kalon Ho; John A Spertus; Robert W Yeh; Jordan B Strom Journal: Heart Date: 2019-12-19 Impact factor: 5.994
Authors: Mohammed Qintar; Taishi Hirai; Suzanne V Arnold; Justin Sheehy; James Sapontis; Phil Jones; Yuanyuan Tang; William Lombardi; Dimitri Karmpaliotis; Jeffery Moses; Christian Patterson; William J Nicholson; David J Cohen; John A Spertus; J Aaron Grantham; Adam C Salisbury Journal: Am Heart J Date: 2019-04-26 Impact factor: 4.749
Authors: Yashashwi Pokharel; Puza P Sharma; Mohammed Qintar; Yuan Lu; Yuanyuan Tang; Philip Jones; Rachel P Dreyer; John A Spertus Journal: Atherosclerosis Date: 2017-09-18 Impact factor: 5.162
Authors: Yevgeniy Khariton; Sophia Airhart; Adam C Salisbury; John A Spertus; Kensey L Gosch; J Aaron Grantham; Dimitrios Karmpaliotis; Jeffrey W Moses; William J Nicholson; David J Cohen; William Lombardi; James Sapontis; James M McCabe Journal: JACC Cardiovasc Interv Date: 2018-11-26 Impact factor: 11.195
Authors: Suzanne V Arnold; Anna Grodzinsky; Kensey L Gosch; Mikhail Kosiborod; Philip G Jones; Tracie Breeding; Arooge Towheed; John Beltrame; Karen P Alexander; John A Spertus Journal: Circ Cardiovasc Qual Outcomes Date: 2016-08-16
Authors: Ali Shafiq; Suzanne V Arnold; Kensey Gosch; Faraz Kureshi; Tracie Breeding; Philip G Jones; John Beltrame; John A Spertus Journal: Am Heart J Date: 2016-02-27 Impact factor: 4.749
Authors: Sripal Bangalore; David J Maron; Jerome L Fleg; Sean M O'Brien; Charles A Herzog; Gregg W Stone; Daniel B Mark; John A Spertus; Karen P Alexander; Mandeep S Sidhu; Glenn M Chertow; William E Boden; Judith S Hochman Journal: Am Heart J Date: 2018-08-01 Impact factor: 4.749