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European Heart Journal 1997 18(3):414-419;
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European Society of Cardiology

Measuring functional status of chronic coronary patients

Reliability, validity and responsiveness to clinical change of the reduced version of the Duke Activity Status Index (DASI)

J. Alonso*,, G. Permanyer-Miralda{dagger}, P. Cascant{dagger}, C. Brotons{dagger}, L. Prieto* and J. Soler-Soler{dagger}

*Health Services Research Unit, Institut Municipal d'Investigació Mèdica (IMIM) Barcelona, Spain
{dagger}Unit of Clinical Epidemiology of the Department of Cardiology, Hospital General Universitari ‘Vail d'Hebron’ Barcelona, Spain

Received 29 July 1996; accepted 1 August 1996.

Correspondence: Dr Jordi Alonso, Health Services Research Unit, IMIM, Carrer del Doctor Aiguader 80, E-08003 Barcelona, Spain

Abstract

AIMS: Health-related quality of life assessment may be useful for understanding the variability in functioning of patients with a similar level of clinical impairment. We assessed the reliability, validity and responsiveness to clinical change of a reduced version of the Duke Activity Status Index (DASI) in chronic coronary patients.

METHODS AND RESULTS: The reduced version of the DASI, a measure of self-reported functional capacity, was administered twice to two groups of patients: 46 stable coronary heart disease outpatients were tested and re-tested 2 weeks after their initial visit; and 44 patients undergoing elective angioplasty for angina pectoris were evaluated the day before and one month after the procedure. The Canadian Cardiovascular Society (CCS) functional grade was assessed in all patients, and a treadmill exercise test was performed sequentially (before and after the procedure) in angioplasty patients. Cronbach's alpha reliability coefficients for reduced DASI scores were high (between 0·81 and 0·89). Correlations of the reduced DASI scores with CCS grade and exercise test duration were moderately high (r= – 0·51 and r=0·45, respectively). Improvement after angioplasty as assessed by the reduced DASI scores was important (effect size=0·75, P<0·001).

CONCLUSION: The reduced DASI is reliable, valid and responsive to clinical changes. Health-related quality of life measures may be useful in monitoring coronary patients.

Key Words: Health-related quality of life • functional capacity • chronic coronary patients • questionnaires • validity • reliability


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