A self-administered questionnaire for detection of unrecognised coronary heart disease

Abstract

Abstract:On an individual and a population basis, an increased incidence of coronary heart disease is associated with classical cardiovascular risk factors, but many cases occur in people not identified as at high risk. Conversely, many people at high statistical risk do not develop coronary disease. We used a questionnaire to identify unrecognised coronary heart disease in people attending large-scale health survey centres. Participants were required to report the presence and characteristics of any chest pain. Those returning responses consistent with myocardial ischaemia were offered treadmill exercise ECG tests. Over 18 months, 4070 questionnaires were returned. Of 475 respondents offered testing, 229 (198 male, 131 female) accepted. Thirty-two subjects (15 male, 17 female: a detection rate of 13.9 per cent of those assessed as likely on questionnaire, or 0.8 per cent of all respondents) had results consistent with significant coronary heart disease. Follow-up was available in 30 cases. There was no difference in classical risk-factor distribution (including multivariate risk percentiles: 42.4 (male) and 46.7 (female)) between those newly diagnosed with coronary heart disease and their community counterparts. More women than men were identified as suffering from unrecognised coronary heart disease, with a preponderance of younger women. Cost per case identified was A$l220. Screening by self-administered questionnaire is a useful and relatively cost-effective means of identifjmg unrecognised coronary heart disease. (Aust N ZJPublic Health 1997; 21: 545-7) N a population basis, an increased incidence of coronary heart disease is associated with 0 higher levels of classical cardiovascular risk factors, considered to be clinical or biochemical markers of a statistically increased likelihood of having or developing the disease.' Much coronary heart disease morbidity and mortality occurs in people not classified as at excessively high risk. This is because, at least partly, of the high proportion of the population who fall into the mild-to-moderate-risk group and to the complex multifactorial interactions involved in the development of coronary heart disease. Population screening on the basis of classical risk factors is therefore likely to miss a significant number of people who warrant further investigation Correspondence to Dr

Development of a Comprehensive Heart Disease Knowledge Questionnaire

“…We did not review scales that included a majority of open-ended or Likert-scale type questions where there was not an obvious correct answer 7-11 or scales that focused specifically on detection, as opposed to more general knowledge of heart disease. 12 We also excluded from the review any studies that included participants aged 18 and younger, 13, 10,14 since the current study's samples comprised of participants 18 and older. Sixteen scales ultimately met our criteria for review.…”

Diagnosis and Management of Chronic Coronary Artery Disease

“…The prevalence of obstructive lesions in coronary angiography ranged from 21% to 70% in studies on asymptomatic patients with a positive exercise electrocardiogram [85][86][87][88]. However, in a meta-analysis based on 44 studies where stress echocardiography and single photon emission tomography (SPECT) were directly compared in patients without prior acute myocardial infarction and without past history of known ischemic heart disease, the two techniques detected obstructive CAD with a sensitivity of 85% and 87% and a specificity of 77% and 64% respectively [84].…”

Self-assessment of health and social care needs by older people

“…The structure and format of the self-assessments, the issues covered and the predictive or diagnostic nature of the assessments were also reviewed. 45,46,47 There were a very small number of more unusual self-assessments such as urine dipstick by post, 48 and questionnaires via the Internet. 16,17,18,19,20,21,22 hearing loss, 23,24,25,26,27,28 nutrition, 29,30 mobility and function 31,32 and oral health.…”