Chan Paul S, Jones Philip G, Arnold Suzanne A, Spertus John A
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.).
Circ Cardiovasc Qual Outcomes. 2014 Sep;7(5):640-7. doi: 10.1161/CIRCOUTCOMES.114.000967. Epub 2014 Sep 2.
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).
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.
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.
临床试验和国家绩效指标越来越要求报告患者对自身健康状况的看法，包括症状、功能和生活质量。尽管西雅图心绞痛问卷（SAQ）是一种经过验证的针对冠状动脉疾病（CAD）的特定疾病健康状况工具，具有较高的重测信度、预测能力和反应性，但其在常规临床实践中的应用受到一定限制，部分原因在于其长度（19项）。
利用来自5个多中心登记处的10408例CAD患者的数据，我们在稳定型CAD患者、接受经皮冠状动脉介入治疗的患者以及急性心肌梗死后的患者中推导并验证了SAQ的缩短版（SAQ - 7）。我们将SAQ - 7与完整的SAQ进行比较，检验其心理测量特性。从身体限制、心绞痛频率和生活质量领域中确定了7项用于SAQ - 7，与每个原始SAQ领域的一致性水平较高（0.88 - 1.00）。SAQ - 7显示出良好的结构效度（与加拿大心血管学会心绞痛分级相比），稳定型CAD患者和接受经皮冠状动脉介入治疗的患者的相关性分别为0.62和0.38。它在稳定型CAD患者中具有高度可重复性（组内相关系数≥0.78），在经皮冠状动脉介入治疗后的患者中表现出优异的反应性（每个SAQ领域≥18分）。最后，SAQ - 7可预测1年死亡率和再入院率。
为提高测量CAD患者报告结局的可行性，我们开发并验证了一种缩短的7项SAQ工具，用于临床试验和常规护理。
