Rose Angina Questionnaire: Validation in emergency department to detect myocardial infarction in a tertiary hospital of eastern Nepal

Abstract

Background: Rose Angina Questionnaire (RAQ) is a useful screening questionnaire for ischemic heart disease validated in different settings; however, its diagnostic ability to predict myocardial infarction (MI) in the emergency is less clear. Objectives: To find out the usefulness of RAQ to predict MI in patients presenting to the emergency. Methods: A cross-sectional study was conducted at the BP Koirala Institute of Health Sciences (BPKIHS), a teaching hospital in eastern Nepal from 1 January to 30 March 2017, after ethical clearance from the Institutional Review Committee. Informed consent was obtained from the patients for their anonymised information to be published in this study The samples were collected from 100 patients with chest pain aged 40 to 70 years presenting to the emergency. RAQ was applied and its performance to detect MI was compared with emergency and cardiologist diagnosis of MI. Sensitivity, specificity, positive predictive value and negative value were calculated along with descriptive analysis. Results: A total of 100 patients were analysed with the mean age of 63.78 years (SD 11.60) and male to female ratio of 1.94. RAQ detected 58 cases (63.8%) with emergency department (ED) diagnosis of MI (true positive) and identified 3 (33.3%) cases with non-MI (true negative). The true positive rate for RAQ to detect MI after cardiologist consultation was 71.6%. RAQ had a sensitivity of 84.91% (95% confidence interval (CI) 72.41% –93.25%) to detect positive troponin, 63.74% (52.99–73.56) to detect positive electrocardiogram (ECG) and 71.60% (95% CI 60.5% to 81.07%) to detect final diagnosis of MI. Conclusion: RAQ is a good screening tool to detect MI in the emergency that can be used in isolation or in combination with other diagnostic modalities to detect it early.

Prevalence, pattern and determinants of chronic disease multimorbidity in Nepal: secondary analysis of a national survey

“…23 For diagnosing CAD, the survey used the (a) information on self-reported admission for myocardial infarction, percutaneous coronary angioplasty or coronary artery bypass surgery; (b) ECG test and (c) responses on the Rose Angina questionnaire. 25 Details are given in the survey report. 23 CA diagnosis was confirmed as informed by the participants.…”

Disparities in Reporting a History of Cardiovascular Disease Among Adults With Limited English Proficiency and Angina

“… 17 , 22 Additionally, the questionnaire has demonstrated value in detecting coronary heart disease and myocardial infarction in diverse populations. 23 , 24 , 25 , 26 , 27 Specifically, the Rose questionnaire has been studied in Spanish-speaking populations and was found to be a reliable tool. 27 Definitions for grade of angina are defined in the eAppendix in the Supplement .…”

“…The questionnaire has high specificity (97%) and moderate sensitivity (approximately 83%) to detect angina pectoris, myocardial infarction, and intermittent claudication . Additionally, the questionnaire has demonstrated value in detecting coronary heart disease and myocardial infarction in diverse populations . Specifically, the Rose questionnaire has been studied in Spanish-speaking populations and was found to be a reliable tool .…”