Wood Kathryn A, Jin Yutong, Krafty Robert T, James Jameze H, Iyer Sivaraman K, Badhwar Nitish
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, 30322, USA.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
Health Qual Life Outcomes. 2025 Jun 7;23(1):59. doi: 10.1186/s12955-025-02385-9.
Disease-specific patient reported outcome measures (PROMs) are widely used to evaluate not only a patient's view of their symptoms, functional status, and health related quality of life, but also clinical benefit of treatments. The Patient Perspective of Arrhythmia Questionnaire (PPAQ) was initially developed as a self-administered, disease-specific PROM for patients with supraventricular tachycardia (SVT) assessing the impact of the arrhythmia and symptoms on patients' daily activities and physical, emotional, and social functioning. Preliminary evidence of content and construct validity has been previously demonstrated, but only in SVT patients in the U.S. and Poland. The aim of this study was to further evaluate the concurrent validity of the PPAQ in patients having a variety of arrhythmias and to explore whether differences in symptoms existed by gender.
In this cross-sectional study, adult cardiac arrhythmia outpatients from a tertiary care, academic medical center completed the 6-item PPAQ, the SF-12, a Fatigue Visual Analog Scale (VAS), the Brief Symptom Inventory (BSI), and the Patient Health Questionnaire (PHQ-9). Included were patients with atrial fibrillation (82.4%), ventricular tachycardia (15.7%), and atrial tachycardia (2%). Descriptive statistics and independent t-tests, pairwise comparisons with Pearson correlations, Goodman Kruskal gamma statistic for ordinal associations, Cronbach's alpha, and Kuder-Richardson-20 (KR-20) were used to determine concurrent construct validity and internal consistency reliability.
Participants (n=51) had a mean age of 59.4 years (± 12.6), were majority male (66.7%) and Caucasian (75%). Preliminary evidence of concurrent construct validity was found based on moderate to strong correlations (range from 0.4 to 0.7) between the PPAQ and other validated measures, as well as strong internal reliability (KR-20 of 0.80 and Cronbach's alpha of 0.91). The most common symptoms reported were fatigue (60.8%) and heart fluttering (52.9%). Blurred vision (p<0.04), dizziness (p<0.01), and fatigue (p<0.04) were seen significantly more frequently in men compared to women.
Results present additional evidence of the validity and reliability of the PPAQ. The PPAQ comprehensively measures the burden of the disease from cardiac arrhythmia patients' perspective. Validated, reliable, disease-specific PROMs are needed to direct personalized clinical decision-making.
特定疾病的患者报告结局指标（PROMs）不仅被广泛用于评估患者对自身症状、功能状态以及与健康相关的生活质量的看法，还用于评估治疗的临床益处。心律失常患者视角问卷（PPAQ）最初是作为一种针对室上性心动过速（SVT）患者的自填式、特定疾病的PROM开发的，用于评估心律失常和症状对患者日常活动以及身体、情感和社会功能的影响。此前已经证明了其内容效度和结构效度的初步证据，但仅在美国和波兰的SVT患者中。本研究的目的是进一步评估PPAQ在患有各种心律失常的患者中的同时效度，并探讨症状是否存在性别差异。
在这项横断面研究中，来自一家三级医疗学术医学中心的成年心律失常门诊患者完成了6项PPAQ、SF-12、疲劳视觉模拟量表（VAS）、简明症状量表（BSI）和患者健康问卷（PHQ-9）。纳入的患者包括心房颤动患者（82.4%）、室性心动过速患者（15.7%）和房性心动过速患者（2%）。使用描述性统计、独立t检验、Pearson相关性的成对比较、用于有序关联的Goodman Kruskal gamma统计量、Cronbach's alpha和库德-理查森-20（KR-20）来确定同时结构效度和内部一致性信度。
参与者（n = 51）的平均年龄为59.4岁（±12.6），大多数为男性（66.7%），且为白种人（75%）。基于PPAQ与其他验证指标之间的中度至强相关性（范围为0.4至0.7）以及较强的内部信度（KR-20为0.80，Cronbach's alpha为0.91），发现了同时结构效度的初步证据。报告的最常见症状是疲劳（60.8%）和心悸（52.9%）。与女性相比，男性出现视力模糊（p<0.04）、头晕（p<0.01）和疲劳（p<0.04）的频率明显更高。
结果提供了PPAQ效度和信度的更多证据。PPAQ从心律失常患者的角度全面衡量了疾病负担。需要经过验证、可靠的特定疾病PROM来指导个性化临床决策。
