COSMIN database

Selecting symptom instruments for cardiovascular populations

Zimmerman, L., Pozehl, B., Vuckovic, K., Barnason, S., Schulz, P., Seo, Y., Ryan, C. J., Zerwic, J. J., and DeVon, H. A.
The purpose of this review is to provide a guide for researchers and clinicians in selecting an instrument to measure four commonly occurring symptoms (dyspnea, chest pain, palpitations, and fatigue) in cardiac populations (acute coronary syndrome, heart failure, arrhythmia/atrial fibrillation, and angina, or patients undergoing cardiac interventions). An integrative review of the literature was conducted. A total of 102 studies summarizing information on 36 different instruments are reported in this integrative review. The majority of the instruments measured multiple symptoms and were used for one population. A majority of the symptom measures were disease-specific and were multi-dimensional. This review summarizes the psychometrics and defining characteristics of instruments to measure the four commonly occurring symptoms in cardiac populations. Simple, psychometrically strong instruments do exist and should be considered for use; however, there is less evidence of responsiveness to change over time for the majority of instruments.
Heart Lung
Publication year:
Symptom status:
Cognitive/mental state
Emotional state
Physical state
Functional status:
Physical functioning
Role functioning
Social functioning
General health perceptions / HRQoL:
Health-related quality of life
Adults (18-65)
Diseases of and symptoms related to the circulatory system
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
ACS Symptom Checklist - Acute Coronary Syndrome Symptom Checklist
AF6 - Atrial Fibrillation 6
AFEQT - Atrial Fibrillation Effect on QualiTy-of-Life   
AFSS - Atrial Fibrillation Severity Scale
ASTA - Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia
Borg Dyspnea Scale
Cardiac Symptom Survey
CCSA - Canadian Cardiovascular Society Angina Classification [alias: Angina pectoris classification]   
CCS-SAF - Canadian Cardiovascular Society-Severity of Atrial Fibrillation
D-12 - Dyspnea-12
DEFS - Dutch Exertion Fatigue Scale
DUFS - Dutch Fatigue Scale
FAS - Fatigue Assessment Scale
FSI - Fatigue Symptom Inventory
HFSAS - Heart Failure Somatic Awareness Scale
HFSPS - Heart Failure Somatic Perception Scale
KCCQ - Kansas City Cardiomyopathy Questionnaire
MAFSI - Mayo AF-Specific Symptom Inventory
MAPMISS - McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS)
MDASI-HF - MD Anderson Symptom Inventory-Heart Failure
MDP - Multidimensional Dyspnea Profile
MFI - Multidimensional Fatigue Inventory (versions: MFI-20)   
MIVE - Maastricht Interview for Vital Exhaustion
MQ - Maastricht Vital Exhaustion Questionnaire
MRC Scale - Medical Research Council Scale   
MSAS-HF - Memorial Symptom Assessment Scale Heart Failure
MSAS - Memorial Symptom Assessment Scale (modifications exist for family caregivers and for hospice staff)
POMS-F - Profile of Mood States-Fatigue
PROMIS Fatigue (versions: Short Form (v.1.0); Fatigue Multiple Sclerosis)
Rose Dyspnea Scale
Rose Questionnaire
SACSI - Symptoms of Acute Coronary Syndrome Inventory
SAQ - Seattle Angina Questionnaire
SSQ-HF - Symptom Status Questionnaire-Heart Failure
Symptoms Checklist
Toronto-SCL - Toronto Symptoms Checklist [alias: SCL - Symptom Checklist]
U22 protocol