Quality of Life Outcomes With a Risk-Based Precision Testing Strategy Versus Usual Testing in Stable Patients With...

Area of Science:

• Cardiology
• Clinical Trials
• Health Outcomes Research

Background:

• The PRECISE trial evaluated a precision diagnostic testing strategy against usual testing in patients with stable chest pain and suspected coronary artery disease.
• Quality of Life (QOL) was a key secondary endpoint in this prospective randomized trial.

Purpose of the Study:

• To compare the QOL outcomes between a precision diagnostic testing strategy and usual testing in patients with stable chest pain.
• To assess the impact of different diagnostic strategies on patient-reported health status and satisfaction.

Main Methods:

• QOL was assessed using structured interviews, including the Seattle Angina Questionnaire (SAQ-19) and EQ-5D, at baseline and at 45 days, 6 months, and 12 months postrandomization.
• The primary QOL comparison focused on the 6-month SAQ Summary score, with high data collection rates ensuring robust analysis.
• Comparisons were performed based on the initial randomization assignment for each patient.

Main Results:

• Both the Precision Strategy and Usual Testing groups showed substantial improvements in mean SAQ Summary scores from baseline to 6 months.
• No statistically significant or clinically meaningful differences in SAQ scores or generic health status (EQ-5D) were observed between the two groups at any follow-up point.
• By 6 months, a similar proportion of patients (66%) in both groups were free of chest pain, and care satisfaction was high and comparable.

Conclusions:

• Angina-related and overall QOL significantly improved in stable patients with suspected coronary artery disease within the first 6 months.
• The observed QOL improvements were independent of the diagnostic testing strategy employed (precision vs. usual care).
• These findings suggest that current diagnostic approaches effectively manage QOL in this patient population.