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Coronary revascularisation outcome questionnaire (CROQ): development and validation of a new, patient based measure of outcome in coronary bypass surgery and angioplasty
  1. S Schroter*,
  2. D L Lamping
  1. Health Services Research Unit, London School of Hygiene & Tropical Medicine, London, UK
  1. Correspondence to:
    Dr Sara Schroter
    BMJ Editorial Office, BMA House, Tavistock Square, London WC1H 9JR, UK;


Objective: To describe the development and scientific validation of a new patient based measure, the coronary revascularisation outcome questionnaire (CROQ), to evaluate health outcomes and quality of life before and after coronary artery bypass grafting and percutaneous transluminal coronary angioplasty.

Design and setting: Psychometric validation study conducted with patients from three hospitals in the UK.

Patients: Two independent field tests were conducted by postal survey of 714 patients before and 1329 patients after coronary revascularisation to evaluate the measurement properties of the CROQ.

Methods: Qualitative methods including patient interviews were used to develop questionnaire content. A full psychometric evaluation was performed on the survey data.

Results: Psychometric tests with the application of stringent criteria confirmed the acceptability (low missing data, good response rates), scaling assumptions (good item convergent and discriminant validity), reliability (good internal consistency and reproducibility), validity (good content and construct validity), and responsiveness of the CROQ.

Conclusions: The CROQ is a practical and scientifically sound patient based measure of outcome developed using psychometric methods. It captures aspects of recovery not addressed in other cardiac questionnaires and has been shown to be a highly responsive instrument that will be useful in evaluating outcomes in clinical trials.

  • CABG, coronary artery bypass grafting
  • CCS, Canadian Cardiovascular Society
  • CROQ, coronary revascularisation outcome questionnaire
  • NYHA, New York Heart Association
  • PTCA, percutaneous transluminal coronary angioplasty
  • SAQ, Seattle angina questionnaire
  • SF-36, short form 36
  • bypass
  • angioplasty
  • quality of life
  • questionnaire

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  • * Institutional affiliations: S Schroter is employed by the BMJ and is an Honorary Lecturer at the London School of Hygiene & Tropical Medicine.

  • Funded by: The NHS Executive/North Thames Research and Development Programme (through S Schroter’s PhD fellowship).

  • Portions of this paper were presented at the 5th, 7th, and 8th annual meetings of the International Society for Quality of Life Research (1998–2001).

    Institutions where work was done: London School of Hygiene & Tropical Medicine, Royal Brompton & Harefield Trust Hospitals, and Wythenshawe Hospital.

    Copies of the CROQ and the SPSS program for scoring the CROQ can be obtained from Dr S Schroter.