Health and Quality of Life Outcomes (Dec 2020)

Psychometric evaluation of a Canadian version of the Seattle Angina Questionnaire (SAQ-CAN)

  • Oluwaseyi A. Lawal,
  • Oluwagbohunmi Awosoga,
  • Maria J. Santana,
  • Matthew T. James,
  • Danielle A. Southern,
  • Stephen B. Wilton,
  • Michelle M. Graham,
  • Merrill Knudtson,
  • Mingshan Lu,
  • Hude Quan,
  • William A. Ghali,
  • Colleen M. Norris,
  • Tolulope Sajobi,
  • for the APPROACH Investigators

DOI
https://doi.org/10.1186/s12955-020-01627-2
Journal volume & issue
Vol. 18, no. 1
pp. 1 – 10

Abstract

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Abstract Background The Seattle Angina Questionnaire (SAQ) is a widely-used patient-reported outcomes measure in patients with heart disease. This study assesses the validity and reliability of the SAQ in a Canadian cohort of individuals with stable angina. Methods and results Data are from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) registry, a population-based registry of patients who received cardiac catheterization in Alberta, Canada. The cohort consists of 4052 patients undergoing cardiac catheterization for stable angina and completed the SAQ within 2 weeks. Exploratory factor analysis and confirmatory factor analysis (CFA) were used to assess the factorial structure of the SAQ. Internal and test–retest reliabilities of a new measure (i.e., SAQ-CAN) was measured using Cronbach α and intraclass correlation coefficient, respectively. CFA model fit was assessed using the root mean square error of approximation (RMSEA) and comparative fit index (CFI). Construct validity of the SAQ-CAN was assessed in relation to Hospital Anxiety and Depression Scales (HADS), Euro Quality of life 5 dimension (EQ5D), and original SAQ. Of the 4052 patients included in this analysis, 3281 (80.97%) were younger than 75 years old, while 3239 (79.94%) were male. Both exploratory and confirmatory factor analyses revealed a four-factorial structure consisting of 16 items that provided a better fit to the data (RMSEA = 0.049 [90% CI = (0.047, 0.052)]; CFI = 0.975). The 16-item SAQ demonstrated good to excellent internal reliability (Cronbach’s α range from 0.77 to 0.90), moderate to strong correlation with the Original SAQ and EQ5D but negligible correlations with HADS. Conclusion The SAQ-CAN has acceptable psychometric properties that are comparable to the original SAQ. We recommend its use for assessing coronary health outcomes in Canadian patients with Coronary Artery Disease.

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