Symptomatic peripheral arterial disease: the value of a validated questionnaire and a clinical decision rule.
Symptomatic peripheral arterial disease: the value of a validated questionnaire and a clinical decision rule.
复制标题
有症状的外周动脉疾病：经过验证的问卷和临床决策规则的价值。
DOI：
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
M. Prins
中科院分区：
文献类型：
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作者：
B. Bendermacher;J. Teijink;E. Willigendael;M. Bartelink;H. Büller;R. Peters;J. Boiten;M. Langenberg;M. Prins
背景
如果一份经过验证的问卷应用于报告有间歇性跛行症状的患者时，能够充分区分患有和不患有外周动脉疾病的患者，那么全科医生就可以避免踝臂指数的诊断测量。
目的
调查一般实践中的爱丁堡跛行问卷 (ECQ)，并根据危险因素制定临床决策规则，使全科医生能够轻松评估外周动脉疾病的可能性。
研究设计
一项观察性研究。
设置
荷兰的一般做法。
方法
这项观察性研究纳入了 55 岁以上因提示间歇性跛行或具有一个危险因素的症状而去看全科医生的患者。进行 ECQ 和踝肱指数。外周动脉疾病的患病率定义为踝臂指数<0.9，与使用逻辑回归分析的危险因素相关，并在此基础上制定了临床决策规则，并与外周动脉疾病的存在相关。
结果
在 4790 名因间歇性跛行症状去看全科医生的患者中，有 4527 名符合分析条件。该组外周动脉疾病患病率为48.3%。 ECQ的敏感性仅为56.2%。临床决策规则（包括年龄、男性、吸烟、高血压、高胆固醇血症和 ECQ 阳性）中外周动脉疾病的患病率从最低类别的 14% 增加到最高类别的 76%。
结论
这项研究表明，单独使用 ECQ 来检测外周动脉疾病患者的诊断价值不足。尽管我们的临床决策规则可以帮助区分外周动脉疾病的极高患病率和极低患病率，但对于有间歇性跛行主诉的患者，应进行踝肱指数来诊断外周动脉疾病。
BACKGROUND
If a validated questionnaire, when applied to patients reporting with symptoms of intermittent claudication, could adequately discriminate between those with and without peripheral arterial disease, GPs could avoid the diagnostic measurement of the ankle brachial index.
AIM
To investigate the Edinburgh Claudication Questionnaire (ECQ) in general practice and to develop a clinical decision rule based on risk factors to enable GPs to easily assess the likelihood of peripheral arterial disease.
DESIGN OF STUDY
An observational study.
SETTING
General practice in The Netherlands.
METHOD
This observational study included patients of > or =55 years visiting their GP for symptoms suggestive of intermittent claudication or with one risk factor. The ECQ and the ankle brachial index were performed. The prevalence of peripheral arterial disease, defined as an ankle brachial index <0.9, was related to risk factors using logistic regression analyses, on which a clinical decision rule was developed and related to the presence of peripheral arterial disease.
RESULTS
Of the 4790 included patients visiting their GP with symptoms suggestive of intermittent claudication, 4527 were eligible for analyses. The prevalence of peripheral arterial disease in this group was 48.3%. The sensitivity of the ECQ was only 56.2%. The prevalence of peripheral arterial disease in a clinical decision rule that included age, male sex, smoking, hypertension, hypercholesterolemia, and a positive ECQ, increased from 14% in the lowest to 76% in the highest category.
CONCLUSION
This study indicates that the ECQ alone has an inadequate diagnostic value in detecting patients with peripheral arterial disease. The ankle brachial index should be performed to diagnose peripheral arterial disease in patients with complaints suggestive of intermittent claudication, although our clinical decision rule could help to differentiate between extremely high and lower prevalence of peripheral arterial disease.
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影响因子：
37.8
作者：
Joanne M. Murabito;Ralph B. D’Agostino;H. Silbershatz;Peter W.F. Wilson
通讯作者：
Joanne M. Murabito;Ralph B. D’Agostino;H. Silbershatz;Peter W.F. Wilson
影响因子：
5.3
作者：
Zheng, ZJ;Sharrett, AR;Heiss, G
通讯作者：
Heiss, G
影响因子：
37.8
作者：
NEWMAN, AB;SISCOVICK, DS;WOLFSON, SK
通讯作者：
WOLFSON, SK
影响因子：
8.7
作者：
Newman, AB;Shemanski, L;Siscovick, D
通讯作者：
Siscovick, D