DEVELOPMENT AND EVALUATION OF THE SEATTLE ANGINA QUESTIONNAIRE - A NEW FUNCTIONAL STATUS MEASURE FOR CORONARY-ARTERY DISEASE

Objectives. This study sought to establish the validity, reproducibili ty and responsiveness of the Seattle Angina Questionnaire, a 19-item s elf-administered questionnaire measuring five dimensions of coronary a rtery disease: physical limitation, anginal stability, anginal frequen cy, treatment satisfaction and disease perception. Background. Assessi ng the functional status of patients is becoming increasingly importan t in both clinical research and quality assurance programs. No current functional status measure quantifies all of the important domains aff ected by coronary artery disease. Methods. Cross-sectional or serial a dministration of the Seattle Angina Questionnaire was carried out in f our groups of patients: 70 undergoing exercise treadmill testing, 58 u ndergoing coronary angioplasty, 160 with initially stable coronary art ery disease and an additional 84 with coronary artery disease. Evidenc e of validity was sought by comparing the questionnaire's five scales with the duration of exercise treadmill tests, physician diagnoses, ni troglycerin refills and other validated instruments. Reproducibility a nd responsiveness were assessed by comparing serial responses over a 3 -month interval. Results. All five scales correlated significantly wit h other measures of diagnosis and patient function (r = 0.31 to 0.70, p less than or equal to 0.001). Questionnaire responses of patients wi th stable coronary artery disease did not change over 3 months. The qu estionnaire was sensitive to both dramatic clinical change, as seen af ter successful coronary angioplasty; and to more subtle clinical chang e, as seen among outpatients with initially stable coronary artery dis ease. Conclusions. The Seattle Angina Questionnaire is a valid and rel iable instrument that measures five clinically important dimensions of health in patients with coronary artery disease. It is sensitive to c linical change and should be a valuable measure of outcome in cardiova scular research.