Doctoral candidate validates questionnaire used to assess quality of life in Canadians with coronary artery disease

Coronary artery disease (CAD) is a progressive condition involving narrowing and blocking of the arteries supplying blood to the heart due to a buildup of plaque deposits. The condition impacts one in 12 Canadians ages 20 and older and can lead to premature death, morbidity, ongoing symptoms like chest pain and impaired quality of life.

Scientists and clinicians increasingly recognize the need to not only consider interventions that reduce mortality in CAD patients, but also aim to improve symptoms, daily functioning and quality of life.

To facilitate this, researchers must assess patients’ view of their health and wellbeing as it relates to their quality of life. They do this using patient reported outcome measures (PROMS), which are validated questionnaires that helps patients to directly appraise and report their health status, symptoms and quality of life.

PROMs are important because knowing the patients' perception of their symptoms, quality of life and well-being can facilitate better communication between patients and their attending physicians, allowing for improved shared decision making and disease management that is tailored to individual patient needs.

The Seattle Angina Questionnaire (SAQ) has been translated into dozens of languages and is widely used to collect assess quality of life in individuals with CAD. Despite its wide usage in Canada, the questionnaire hasn’t been specifically validated for Canada—until now.

Oluwaseyi Lawal, a PhD candidate in the Department of Community Health Sciences, tackled this issue in her postdoctoral thesis under the mentorship of her supervisor Dr. Tolu Sajobi, PhD, associate professor of biostatistics in the Department of Community Health Sciences and a member of the Libin Cardiovascular Institute.

She explains it’s an important project because failing to use validated PROM tools may misrepresent patients’ perspectives about their health and quality of life, resulting in unmet needs and inadequate or inappropriate health-care decisions.

Using data from the Alberta Provincial Project on Outcome Assessment in Coronary Heart Disease, a population-based registry of all individuals who received cardiac angiogram in Alberta, Lawal investigated the validity of the SAQ and the alternative Canadian version (SAQ-CAN).

Her work found that the SAQ-CAN, which comprises of 16 questions, was more valid and reliable for measuring health status and quality of life in Canadian CAD patients than the SAQ.

Lawal’s motivation to undertake this research was borne of personal experience.

While a master’s student studying statistics at the University of Calgary, Lawal had some health concerns. It was from these situations that she realized the importance of patient involvement in clinical decision making.

“I believe clinical decisions about a patient’s health should be based on shared-decision making with the patient and not solely by the healthcare provider,” she says. “Health care providers should show patients what is on the table as far as treatments go and what the system offers and then allow the patient to decide.”

Lawal successfully defended her doctoral thesis in March, 2023.