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Protocol - Angina

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Protocol Name from Source:

The Expert Review Panel has not reviewed this measure yet.

Availability:

Publicly available

Description:

The interviewer asks the respondent about his/her personal history of angina and chest discomfort characteristics to determine presence of angina.

Protocol:

1. Has a doctor ever told you that you had angina?

[] 1 Yes

[] 0 No

[] 9 Don't Know

2. Any chest discomfort ever/since last exam or medical history update?

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Don't Know

If Yes, fill the following and continue.

If No, end of protocol.

(please provide narrative comments in addition to checking the appropriate boxes)

3. Chest discomfort with exertion or excitement

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Don't Know

4. Chest discomfort when quiet or resting

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Don't Know

Chest Discomfort Characteristics

5. ____ / ___ ___ ___ ___ Date of onset (mo/yr)

[] 99/9999 Unknown

6. ___ ___ ___ Usual duration (minutes: 1=1 min or less, 900=15 hrs or more)

[] 999 Unknown

7. ___ ___ ___ Longest duration (minutes: 1=1 min or less, 900=15 hrs or more)

[] 999 Unknown

8. Location

[] 0 No

[] 1 Central sternum and upper chest

[] 2 Left upper Quadrant

[] 3 Left lower ribcage

[] 4 Right chest

[] 5 Other

[] 6 Combination

[] 9 Unknown

9. Radiation

[] 0 No

[] 1 Left shoulder or left arm

[] 2 Neck

[] 3 Right shoulder or arm

[] 4 Back

[] 5 Abdomen

[] 6 Other

[] 7 Combination

[] 9 Unknown

10. ___ ___ ___ Frequency (number in past month)

[] 999 Unknown

11. ___ ___ ___ Frequency (number in past year)

[] 999 Unknown

12. Type

[] 1 Pressure, heavy, vise

[] 2 Sharp

[] 3 Dull

[] 4 Other

[] 9 Unknown

13. Relief by nitroglycerine in <15 minutes

[] 0 No

[] 1 Yes

[] 8 Not tried

[] 9 Unknown

14. Relief by rest in <15 minutes

[] 0 No

[] 1 Yes

[] 8 Not tried

[] 9 Unknown

15. Relief spontaneously in <15 minutes

[] 0 No

[] 1 Yes

[] 8 Not tried

[] 9 Unknown

16. Relief by other cause in <15 minutes

[] 0 No

[] 1 Yes

[] 8 Not tried

[] 9 Unknown

17. Since your last exam, have you been told by a doctor you had a heart attack?

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Unknown

CHD First Opinions

18. Angina pectoris in interim

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Unknown

19. Angina pectoris since revascularization procedure

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Unknown

20. Coronary insufficiency in interim

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Unknown

21. Myocardial infarct in interim

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Unknown

22. Comments

________________________________________________________

Diagnostic Criteria:

History of:

1) chest discomfort with characteristic location (usually substernally or just to left of sternum but can be anywhere from epigastrium to the neck) and duration (lasting less than 30 minutes), and

2) provoked by exertion or emotional stress, and

3) relieved by rest or nitroglycerin.

The measurement then can result in four categories:

1. Typical angina (definite): all three characteristics

2. Atypical angina (probable): two characteristics

3. Non-cardiac chest pain: one or none of the characteristics

4. No chest pain

Note: Women are less likely to have typical chest pain either in terms of precipitating causes or in location of discomfort.

Personnel and Training Required

An interviewer who is trained to conduct personal interviews with individuals from the general population is required. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews.* The interviewer should be trained to prompt respondents further if a "don't know" response is provided.

*There are multiple modes to administer this question (e.g., paper-and-pencil and computer-assisted interviews).

Equipment Needs

None

Requirements

Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Self-administered

Life Stage:

Adult

Specific Instructions:

If the respondent answers "yes" to question 1 or question 2, then the interviewer will administer the remaining protocol questions. If the respondent answers "no" or "don't know" to question 1 and question 2, the protocol is deemed complete.

Research Domain Information

Release Date:

September 9, 2009

Definition

Measure to assess chest discomfort that may indicate the presence of angina.

Purpose

To determine the presence of angina as a sign of significant coronary artery disease. Patients with angina are at risk of developing a heart attack or myocardial infarction.

Selection Rationale

Vetted against other protocols, the Cardiovascular Health Study (CHS) and Framingham Heart Study (FHS) questions were selected because they come from major U.S. health studies and collect the necessary information to determine the presence of angina.

Language

English, Spanish

Standards

StandardNameIDSource
Common Data Elements (CDE)Person Angina Indicator2935403CDE Browser
Logical Observation Identifiers Names and Codes (LOINC)PhenX - angina protocol62395-9LOINC

Process and Review

The Expert Review Panel has not reviewed this measure yet.

Source

U.S. Department of Health and Human Services. National Institutes of Health. National Heart, Lung and Blood Institute. Cardiovascular Health Study (CHS). Baseline Medical History Questionnaire. Page 4. Question 4 (source for question 1 in Protocol Text).

U.S. Department of Health and Human Services. National Institutes of Health. National Heart, Lung and Blood Institute and Boston University. Framingham Heart Study (FHS). Cohort Examination 29. Page 35. Medical History - Heart (source for questions 2–22 in Protocol Text).

Gibbons, R. J., Chatterjee, K., Daley, J., & American College of Cardiology/American Heart Association, American College of Physicians-American Society of Internal Medicine (ACC/AHA/ACP-ASIM). (2002). Guidelines for the management of patients with chronic stable angina. Journal of the American College of Cardiology, 41, 160–168 (source for Diagnostic Criteria).

General References

Ives, D. G., Fitzpatrick, A. L., Bild, D. E., Psaty, B. M., Kuller, L. H., Crowley, P. M., Cruise, R. G., & Theroux, S. (1995). Surveillance and ascertainment of cardiovascular events. The Cardiovascular Health Study. Annals of Epidemiology, 5, 278–285.

Psaty, B. M., Kuller, L. H., Bild, D., Burke, G. L., Kittner, S. J., Mittelmark, M., Price, T. R., Rautaharju, P. M., & Robbins, J. (1995) Methods of assessing prevalent cardiovascular disease in the Cardiovascular Health Study. Annals of Epidemiology, 5(4), 270–277.

Protocol ID:

40601

Variables:

Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX040601_Have_AnginaPX040601010000Has a doctor ever told you that you had angina?4N/A
PX040601_Chest_Discomfort_Since_LastExamPX040601020000Any chest discomfort ever/since last exam or medical history update?4N/A
PX040601_Chest_Discomfort_ExertionPX040601030000Chest discomfort with exertion or excitement4N/A
PX040601_Chest_Discomfort_QuitePX040601040000Chest discomfort when quiet or resting4N/A
PX040601_Chest_Discomfort_Onset_MonthPX040601050100Chest Discomfort Characteristics Date of onset (mo)4N/A
PX040601_Chest_Discomfort_Onset_Month_CodedPX040601050101Chest Discomfort Characteristics Date of onset (mo)4N/A
PX040601_Chest_Discomfort_Onset_YearPX040601050200Chest Discomfort Characteristics Date of onset (yr)4N/A
PX040601_Chest_Discomfort_Onset_Year_CodedPX040601050201Chest Discomfort Characteristics Date of onset (yr)4N/A
PX040601_Chest_Discomfort_Usual_Duration_MinutePX040601060000Chest Discomfort Characteristics Usual duration (minutes)4N/A
PX040601_Chest_Discomfort_Usual_Duration_Minute_CodedPX040601060100Chest Discomfort Characteristics Usual duration (minutes)4N/A
PX040601_Chest_Discomfort_Longest_Duration_MinutePX040601070000Chest Discomfort Characteristics Longest duration (minutes)4N/A
PX040601_Chest_Discomfort_Longest_Duration_Minute_CodedPX040601070100Chest Discomfort Characteristics Longest duration (minutes)4N/A
PX040601_Chest_Discomfort_LocationPX040601080000Chest Discomfort Characteristics Location4N/A
PX040601_Chest_Discomfort_RadiationPX040601090000Chest Discomfort Characteristics Radiation4N/A
PX040601_Chest_Discomfort_Frequency_Past_MonthPX040601100000Chest Discomfort Characteristics Frequency (number in past month)4N/A
PX040601_Chest_Discomfort_Frequency_Past_Month_CodedPX040601100100Chest Discomfort Characteristics Frequency (number in past month)4N/A
PX040601_Chest_Discomfort_Frequency_Past_YearPX040601110000Chest Discomfort Characteristics Frequency (number in past year)4N/A
PX040601_Chest_Discomfort_Frequency_Past_Year_CodedPX040601110100Chest Discomfort Characteristics Frequency (number in past year)4N/A
PX040601_Chest_Discomfort_TypePX040601120000Chest Discomfort Characteristics Type4N/A
PX040601_Chest_Discomfort_Relief_NitroglycerinePX040601130000Chest Discomfort Characteristics Relief by nitroglycerine in <15 minutes4N/A
PX040601_Chest_Discomfort_Relief_RestPX040601140000Chest Discomfort Characteristics Relief by rest in <15 minutes4N/A
PX040601_Chest_Discomfort_Relief_SpontaneouslyPX040601150000Chest Discomfort Characteristics Relief spontaneously in <15 minutes4N/A
PX040601_Chest_Discomfort_Relief_OtherPX040601160000Chest Discomfort Characteristics Relief by other cause in <15 minutes4N/A
PX040601_Heart_Attack_Since_LastExamPX040601170000Since your last exam, have you been told by a doctor you had a heart attack?4N/A
PX040601_Angina_Pectoris_InterimPX040601180000CHD First Opinions Angina pectoris in interim4N/A
PX040601_Angina_Pectoris_RevascularizationPX040601190000CHD First Opinions Angina pectoris since revascularization procedure4N/A
PX040601_Myocardial_Infarct_InterimPX040601210000CHD First Opinions Myocardial infarct in interim4N/A
PX040601_CommentsPX040601220000Comment4N/A
PX040601_Coronary_Insufficiency_InterimPX040601200000CHD First Opinions Coronary insufficiency in interim4N/A