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Abstract
Background
There is a paucity of preference-based (utility) measures of health-related quality of life for patients with ischemic heart disease (IHD); in contrast, the Seattle Angina Questionnaire (SAQ) is a widely used descriptive measure. Our objective was to perform a systematic review of the literature to identify IHD studies reporting SAQ scores in order to apply a mapping algorithm to convert these to preference-based scores for secondary use in economic evaluations.
Methods
Relevant articles were identified in MEDLINE (Ovid), EMBASE (Ovid), Cochrane Library (Wiley), HealthStar (Ovid), and PubMed from inception to 2012. We previously developed and validated a mapping algorithm that converts SAQ descriptive scores to European Quality of Life-5 Dimensions (EQ-5D) utility scores. In the current study, this mapping algorithm was used to estimate EQ-5D utility scores from SAQ scores.
Results
Thirty-six studies met the inclusion criteria. The studies were categorized into three groups, ie, general IHD (n=13), acute coronary syndromes (n=4), and revascularization (n=19). EQ-5D scores for patients with general IHD were in the range of 0.605–0.843 at baseline, and increased to 0.649–0.877 post follow-up. EQ-5D scores for studies of patients with recent acute coronary syndromes increased from 0.706–0.796 at baseline to 0.795–0.942 post follow-up. The revascularization studies had EQ-5D scores in the range of 0.616–0.790 at baseline, and increased to 0.653–0.928 after treatment; studies that focused only on coronary artery bypass grafting increased from 0.643–0.788 at baseline to 0.653–0.928 after grafting, and studies that focused only on percutaneous coronary intervention increased in score from 0.616–0.790 at baseline to 0.668–0.897 after treatment.
Conclusion
In this review, we provide a catalog of estimated health utility scores across a wide range of disease severity and following various interventions in patients with IHD. Our catalog of EQ-5D scores can be used in IHD-related economic evaluations.
Supplementary material
The following method describes the search strategy used to collect the references analyzed in this study. This strategy had three primary facets, outlined below.
Identification of materials in the primary databases of medical literature that referenced the Seattle Angina Questionnaire. These databases were MEDLINE (Ovid), EMBASE (Elsevier), OVID HealthStar, MEDLINE (PubMed), and the Cochrane Library (Wiley).
Use of the citation mapping tools Google Scholar (Google), Scopus (Elsevier), and Web of Science (Thomson Reuters), to find all available references to the paper in which Seattle Angina Questionnaire was first described by John Spertus et al in the Journal of the American College of Cardiology in 1995. The search strategy was to locate the original article by Spertus et al and export the references that the tool identified as having cited that article.
Use of the major clinical trial registries to determine the studies that used the SAQ as an outcome measure. These registries have simple search functions, and so our search terms were “Seattle Angina Questionnaire” or “SAQ”. The strategy then underwent peer review by a librarian experienced in the creation and review of systematic search strategies.
Search strategy
The following search strategy was applied to MEDLINE (Ovid), HealthStar (Ovid), and EMBASE (Ovid). It was adapted for use in PubMed by updating the syntax to match that offered in the PubMed search tool. When searching the Cochrane Library, only the words “Seattle Angina Questionnaire” were used. Databases were searched from inception until 2013.
(Development and evaluation of the Seattle Angina Questionnaire: a new functional status measure for coronary artery disease).m_titl.
seattle angina questionnaire.mp.
seattle angina questionnaire.tw.
(seattle adj3 angina).af.
(angina adj3 questionnaire).af.
saq.mp.
or/1–6.
spertus ja.au.
and 8.
Acknowledgments
HCW is supported by a Distinguished Clinical Scientist Award from the Heart and Stroke Foundation of Canada.
Author contributions
HCW was involved in the conception, design, acquisition, analysis and interpretation of the data, and critically revised the manuscript. SFZ was involved in the conception and design, acquisition of data, and interpretation of the data, and drafted the manuscript. WW was involved in conception of the study, performed the systematic search, and revised the manuscript critically. MCB was involved in the acquisition of data, analysis and interpretation of data, and revised the manuscript critically. All authors approved the final manuscript for publication and agree to be accountable for all aspects of the work.
Disclosure
The authors report no competing interests in this work.