We’re currently using the SAQ for a PCI follow up study of about 200 patients. In examining the responses, it seems that there can be some confusion with Question 1, particularly in the highest exertional level. Several patients have crossed out responses in the Severely Limited (1) column only to move them over to the Limited, or did not do for other reasons (6) column and vice versa. It seems that the patients had difficulty differentiating between demanding activities that they normally attempt and are severely limited by angina and activities that they probably wouldn’t attempt in the first place. We would like to know if others have encountered this as well as if contacting patients again to clarify their responses would bias the data.

Joe,
We have had this occur as well. We have interpreted this to be that patients wrestled with whether or not it was their angina that was limiting them and have always used their final response. Being a disease-specific instrument, we are really trying to capture patients’ limitations due to their CAD, as opposed to arthritis or another limiting comorbidity. Often, the interpretation is the same on sequential testing so no bias should be introduced when examining changes in scores. I hope this helps.