Abstract
BackgroundThe Coronary Revascularisation Outcome Questionnaire (CROQ) measures health-related quality of life and outcome of invasive revascularization procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The CROQ has not been properly validated in Norwegian patient populations. The aim of this study was to examine the psychometric properties of the Norwegian CROQ in patients admitted to elective coronary angiographic assessment and receiving PCI. Moreover, to examine its discriminative ability to detect disease severity and effects of invasive coronary treatment.MethodsThe patients (N = 280, Mage = 66.9, SDage = 8.91) completed the CROQ, prior to an elective coronary angiography and at one year follow-up. Analyses included internal consistency, floor and ceiling effects, and confirmatory and exploratory factor analyses of the CROQ. Convergent validity was evaluated by comparing CROQ scores with the RAND-12 measure. Sensitivity to treatment was examined by comparing pre-post effect size differences between the PCI treatment and non-treatment group.ResultsSignificant stenosis qualifying for a PCI was detected in 121 (35.1%) patients. The model fit of the original CROQ factor model was inadequate in the PCI group. All but one of the CROQ items demonstrated ceiling effects. The CROQ failed to discriminate between patients’ disease severity prior to the coronary angiography, or improvement in those receiving versus not receiving PCI.ConclusionThe present study of the Norwegian version of the CROQ identified serious problems with the factor structure, ceiling effects, and lack of sensitivity for disease severity and effects of invasive treatment. Currently, one cannot recommend the use of CROQ in clinical practice.
Highlights
Coronary angiography (CA) combined with intracoronary physiological measurement, is considered the definite diagnostic procedure to identify coronary heart disease [1]
We report relative fit in terms of the Tucker-Lewis Index (TLI) and the Comparative Fit Index (CFI), the model misspecification index root-mean-square error of approximation (RMSEA) [22] and the weighted rootmean-square residual (WRMR)
At post-angiography, the percutaneous coronary intervention (PCI) group consisted of 104 patients (M-age = 67.3, Standard deviation (SD)-age 7.7 and 78.8% males), whereas the non- significant stenosis group consisted of 128 patients (M-age = 67.3; SD-age = 9.0 and 53.1% males)
Summary
Coronary angiography (CA) combined with intracoronary physiological measurement, is considered the definite diagnostic procedure to identify coronary heart disease [1]. Routine assessment with a patient reported outcome measure (PROM) could improve physicians’ understanding of how the disease affects the patients’ daily life, and contribute to quality improvement and clinical research. This is reflected in the European Society of Cardiology (ESC) Guidelines for the diagnosis and management of chronic coronary syndromes, which recommends to include quality of life assessment in the diagnostic process [1]. Coronary Revascularisation Outcome Questionnaire (CROQ) is the only PROM designed to measure health-related quality of life (HRQoL) and presumed sensitive to the effect of invasive revascularization treatment procedures such as PCI or coronary artery bypass graft (CABG) surgery. To examine its discriminative ability to detect disease severity and effects of invasive coronary treatment
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