Background: The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a recently developed disease-specific instrument for measuring health-related quality of life (HRQoL) in patients with chronic heart failure (CHF) regardless of aetiology. Aim: To assess the reliability and validity of the KCCQ in patients with previous myocardial infarction (MI).
Methods and results:In 754 myocardial infarction patients who were discharged alive, we collected clinical data from the patients' medical records. Two and a half years after the acute myocardial infarction, we mailed a self-administered questionnaire to the 548 patients still alive. The response rate was 74%. Internal consistency reliability, assessed with Cronbach's a, ranged 0.66-0.95. Test-retest reliability, tested with an intraclass correlation coefficient (ICC), ranged 0.41-0.83. The pattern of association between similar and dissimilar scales of the KCCQ and Short Form 36 (SF-36) supported the convergent/divergent validity of the KCCQ. Four of the KCCQ scales and the two summary scores discriminated between patients with and without medication for heart failure, and between different levels of left ventricular ejection fraction (LVEF) supporting different groups validity. Conclusions: The Norwegian version of the KCCQ showed acceptable reliability and cross-sectional validity, which support the use of this questionnaire to measure health-related quality of life after myocardial infarction.
Background: The objective was to explore the relationship between left ventricular ejection fraction (LVEF) assessed during hospitalization for acute myocardial infarction (MI) and later healthrelated quality of life (HRQoL).
A computer system to be used in the emergency room has been developed for estimating the risk of acute coronary heart disease (ACHD). The system uses data on 38 case history and clinical variables collected consecutively over a year from 918 patients with acute chest pain. A statistical procedure based on Bayes' formula is used to estimate disease probabilities. A quadratic scoring rule was used for variable selection. The score increased markedly until 15-20 variables had been added, reached a maximum after inclusion of about 30 variables and then deteriorated slightly. Thus, the number of variables carrying additional information on the presence/absence of ACHD seems to be much larger than the number normally utilized by doctors and by other decision support systems. Reclassification into two groups, those with and without ACHD, gives a diagnostic accuracy of 89%. We conclude that analysing detailed case histories by computer is a promising decision support system for use in the emergency room as a supplement to ECG analysis.
The combination of warfarin and aspirin 150 mg daily aiming at a less intense level of anticoagulation than in warfarin therapy alone does not increase the risk of major or fatal haemorrhage.
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