Development and validation of a new Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) with focus on symptom burden

Abstract

BackgroundArrhythmias can appear with a variety of symptoms, all from vague to pronounced and handicapping symptoms. Therefore, patient-reported outcomes (PROs) concerning symptom burden are important to assess and take into consideration in the care and treatment of patients with arrhythmias. The main purpose was to develop and validate a disease-specific questionnaire evaluating symptom burden in patients with different forms of arrhythmias.MethodsA literature review was conducted and arrhythmia patients were interviewed. Identified symptoms were evaluated by an expert panel consisting of cardiologists and nurses working daily with arrhythmia patients. SF-36 and Symptoms Checklist (SCL) were used in the validation of the new questionnaire Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA).Homogeneity was evaluated with Spearman´s correlations and Cronbach´s alpha coefficient (α) was used to evaluate internal consistency. Construct validity was evaluated using item-total correlations and convergent and discriminant validity. For this, Spearman´s correlations were calculated between the ASTA symptom scale, SCL and SF-36. Concurrent validity was validated by Spearman´s correlations between the ASTA symptom scale and SCL.ResultsThe correlations between the different items in the ASTA symptom scale showed generally sufficient homogeneity. Cronbach´s coefficient was found to be satisfactory (α = 0.80; lower bound 95 % CI for α = 0.76). Construct validity was supported by item-total correlations where all items in the symptom scale were sufficiently correlated (≥0.3). Convergent and discriminant validity was supported by the higher correlations to the arrhythmia-specific SCL compared to the generic SF-36. Concurrent validity was evaluated and there were sufficiently, but not extremely strong correlations found between the ASTA symptom scale and SCL.ConclusionsThe nine items of the ASTA symptom scale were found to have good psychometric properties in patients with different forms of arrhythmias. Arrhythmia patients suffer from both frequent and disabling symptoms. The validated ASTA questionnaire can be an important contribution to PROs regarding symptom burden in arrhythmia patients.

Symptom Clusters in Adults With Chronic Atrial Fibrillation

“…Fourth, the symptoms reported in this study may not represent all possible symptoms of AF (e.g. emotional and cognitive symptoms), 48,49 and as a result important clusters or components of clusters may be missing from this report. While we recognize the limitations of our study, we consider this work an important first step towards understanding symptom clusters and factors associated with cluster membership among adults with chronic AF.…”

Gender and age differences in symptoms and health‐related quality of life in patients with atrial fibrillation referred for catheter ablation

“…Scores can be calculated for the symptom scale if at least eight of the nine items are filled out and for the HRQoL scale if 11 of the 13 items are completed. Values range from 0 to 100, where higher scores reflect a higher symptom burden and a worse effect on HRQoL, due to arrhythmia …”

“…The Arrhythmia‐Specific questionnaire in Tachycardia and Arrhythmia (ASTA) was developed in collaboration with patients suffering from arrhythmias and healthcare professionals working with the targeted patient population. The ASTA questionnaire was validated in patients with AF, supraventricular, and ventricular arrhythmias and assesses not only symptoms and HRQoL, but also how palpitations are perceived …”

Long-term efficacy of catheter ablation as first-line therapy for paroxysmal atrial fibrillation: 5-year outcome in a randomised clinical trial

“…We took into account AF episodes >1 min. QoL was assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) physical and mental component scores (range 0–100, higher scores indicating better well-being) and the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) 6 7. In addition, we investigated all deaths to ascertain the cause of death.…”