REPEATABILITY AND VALIDITY OF THE ROSE QUESTIONNAIRE FOR ANGINA-PECTORIS IN THE ATHEROSCLEROSIS RISK IN COMMUNITIES STUDY

Angina pectoris (AP) as determined by the Rose questionnaire was asses sed in nearly 16,000 black and white men and women participating in th e Atherosclerosis Risk in Communities Study, a population study of car diovascular disease in four communities. The questionnaire was adminis tered at yearly intervals and estimates of repeatability were made. Va lidity was assessed indirectly by comparing Rose AP to risk factors, p revalent heart disease, medication use, and thickness of carotid arter y walls as measured by B-mode ultrasound. Using kappa statistics for a greement of positive Rose AP determinations taken 1 year apart, white men show a higher level of agreement than white women (average kappa 0 .36 for white men, 0.30 for white women), and whites show a higher lev el of agreement than blacks (average kappa 0.23 and 0.22 for black men and women, respectively), Rose AP that persists for more than one det ermination is associated with thicker carotid artery walls, greater am ounts of cigarette smoking, greater prevalence of reported heart attac k, and greater use of chest pain medications. A single determination o f severe Rose AP is also associated with thicker carotid artery walls. These data suggest that multiple reports and the more severe grading of Rose AP (pain reported while walking on the level) are likely to in dicate more severe disease; however, a single report using the Rose qu estionnaire appears valid, i.e., moderately associated with disease an d risk factors, and appropriate for use in epidemiological studies.