Development and Validation of a Short Version of the Seattle Angina Questionnaire

Study Questions:

What is the validity of the shortened version of the Seattle Angina Questionnaire (SAQ-7) and its summary score, including its psychometric (validity, reliability, and responsiveness to change) and prognostic properties?

Methods:

Using data from 10,408 patients with coronary artery disease (CAD) from five multicenter registries, the investigators derived and validated a shortened version of the SAQ (SAQ-7) among patients presenting with stable CAD, undergoing percutaneous coronary intervention (PCI), and after acute myocardial infarction. The authors examined the psychometric properties of the SAQ-7 as compared with the full SAQ.

Results:

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 PCI, respectively. It was highly reproducible in patients with stable CAD (intraclass correlation, ≥0.78) and exhibited excellent responsiveness in patients after PCI (≥18 points in each SAQ domain). Finally, the SAQ-7 was predictive of 1-year mortality and readmission.

Conclusions:

The authors concluded that they have validated a shortened 7-item SAQ instrument for use in clinical trials and routine care.

Perspective:

The study investigators derived and validated a 7-item shortened version of the SAQ (SAQ-7), as well as an overall summary score, to facilitate assessments of health status in patients with CAD. The SAQ-7 performed well in patients with stable CAD, undergoing PCI, and presenting with acute myocardial infarction. The SAQ-7 has the potential to improve clinical care by providing physicians with an objective, efficient mechanism to follow the trajectory of their CAD patients’ health status.

Keywords: Myocardial Infarction, Psychometrics, Quality of Life, Surveys and Questionnaires, Health Status, Percutaneous Coronary Intervention


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