One simple claudication question as first step in Peripheral Arterial Disease (PAD) screening: A meta-analysis of the association with reduced Ankle Brachial Index (ABI) in 27,945 subjects

Abstract

Purpose and methodsA meta-analysis using data from seven German population-based cohorts was performed by the German Epidemiological consortium of Peripheral Arterial Disease (GEPArD) to investigate whether one question about claudication is more efficient for PAD screening than established questionnaires. Claudication was defined on the basis of the answer to one question asking for pain in the leg during normal walking. This simple question was compared with established questionnaires, including the Edinburgh questionnaire. The associations of claudication with continuous ABI values and decreased ABI were analyzed by linear and logistic regression analysis, respectively. The results of the studies were pooled in a random effect meta-analysis, which included data from 27,945 individuals (14,052 women, age range 20–84 years).ResultsMeta-analysis revealed a significant negative association between claudication and ABI, which was stronger in men (β = -0.07; 95%CI -0.10, -0.04) than in women (β = -0.02; 95%CI -0.02, -0.01). Likewise, the presence of claudication symptoms was related to an increased odds of a decreased ABI in both men (Odds ratio = 5.40; 95%CI 4.20, 6.96) and women (Odds ratio = 1.99; 95%CI 1.58, 2.51).ConclusionsAsking only one question about claudication was able to identify many individuals with a high likelihood of a reduced ABI with markedly higher sensitivity and only slightly reduced specificity compared to more complex questionnaires. At least in men, this question should be established as first screening step.

Comparison of Doppler and oscillometric methods of assessing ankle-brachial index in non-diabetic premenopausal women in Ghana

“…In this study, we did not nd any difference in mean values of oscillometric-and Doppler-ABIs between patients presenting with leg pain and those without leg pain. This is contrary to a meta-analysis of 27,945 patients from 7 studies that reported lower mean ABI in patients with leg pain 21 .…”

Walking Impairment Questionnaire and Walking Tests are Reliable Indicators of Success of Treatment of Peripheral Artery Disease

“…Therefore, besides walk tests, the WIQ is a practical, reliable, valid, and representative measure of the functional capability in patients with intermittent claudication; it is also an easily obtained indicator of the efficacy of revascularization procedures. 13,33…”

Concept and Methods in Urban Public Health

“…The variety and depth of both the recording of environmental factors and the pheno-and genotypic characterization of the subjects allow further investigation of important questions beyond the existing study results. Furthermore, through the use of highly standardized assessment and database tools, data of this study is still used in big national (e.g., Kieback et al 2019;Bächle et al 2018; De Las Heras Gala 2016) and international research cooperations (e.g., Locke et al 2015;McClelland et al 2015). Overall, many important results regarding environmental issues could be achieved (e.g., Lucht et al 2020;Kartschmit et al 2020;Orban et al 2017;Fuks et al 2016;Hoffmann et al 2015;Hertel et al 2010).…”