BMJ 2002;325:337 ( 10 August )

Letters

Psychological stress and cardiovascular disease

    Rose questionnaire is not what it seems
    Paper doesn't clarify things
    Authors' reply

Rose questionnaire is not what it seems

The first 150 words of the full text of this article appear below.

EDITOR---Macleod et al's paper on stress and cardiovascular disease tells us two things.1 Firstly, the Rose angina questionnaire rather inconveniently does not just measure angina in the sense understood by cardiologists.2 Instead it measures chest pain as understood by everyone else.

Most cases of chest pain in the general population are not due to heart disease, and even in middle aged Scottish men the prevalence of coronary heart disease is low, so the positive predictive value of the Rose questionnaire will be poor.3 The relation between stress and chest pain that the questionnaire measures is only a "bias" in as much as it does not fit into the view of cardiovascular epidemiologists. The effect is real (and has important clinical implications to cardiologists) in that the Rose questionnaire is a superb measure of anxiety in young people but will mislead those who interpret its results too credulously.3 The . . . [Full text of this article]
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This article has been cited by other articles:

  • Macleod, J, Davey Smith, G (2003). Psychosocial factors and public health: a suitable case for treatment?. J. Epidemiol. Community Health 57: 565-570 [Abstract] [Full text]  
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Rapid Responses:

Read all Rapid Responses

correction
John Macleod, et al.
bmj.com, 9 Aug 2002 [Full text]
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