TY - JOUR
T1 - Applicability of the ankle-brachial-index measurement as screening device for high cardiovascular risk: an observational study
AU - Bendermacher, Bianca L. W.
AU - Teijink, Joep A. W.
AU - Willigendael, Edith M.
AU - Bartelink, Marie-Louise
AU - Peters, Ron J. G.
AU - Langenberg, Machteld
AU - Buller, Harry R.
AU - Prins, Martin H.
PY - 2012/7/30
Y1 - 2012/7/30
N2 - Background: Screening with ankle-brachial index (ABI) measurement could be clinically relevant to avoid cardiovascular events in subjects with asymptomatic atherosclerosis. To assess the practical impact of guidelines regarding the use of ABI as a screening tool in general practice, the corresponding number needed to screen, including the required time investment, and the feasibility of ABI performance, was assessed. Methods: An observational study was performed in the setting of 955 general practices in the Netherlands. Overall, 13,038 subjects of >= 55 years presenting with symptoms of intermittent claudication and/or presenting with >= one vascular risk factor were included. Several guidelines recommend the ABI as an additional measurement in selected populations for risk assessment for cardiovascular morbidity. Results: Screening of the overall population of >= 50 years results in approximate to 862 subjects per general practice who should be screened, resulting in a time-requirement of approximately 6 weeks of full time work. Using an existing clinical prediction model, 247 patients per general practice should be screened for PAD by ABI measurement. Conclusion: Screening the entire population of >= 50 years will in our opinion not be feasible in general practice. A more rationale and efficient approach might be screening of subsets of the population of >= 55 years based on a clinical prediction model.
AB - Background: Screening with ankle-brachial index (ABI) measurement could be clinically relevant to avoid cardiovascular events in subjects with asymptomatic atherosclerosis. To assess the practical impact of guidelines regarding the use of ABI as a screening tool in general practice, the corresponding number needed to screen, including the required time investment, and the feasibility of ABI performance, was assessed. Methods: An observational study was performed in the setting of 955 general practices in the Netherlands. Overall, 13,038 subjects of >= 55 years presenting with symptoms of intermittent claudication and/or presenting with >= one vascular risk factor were included. Several guidelines recommend the ABI as an additional measurement in selected populations for risk assessment for cardiovascular morbidity. Results: Screening of the overall population of >= 50 years results in approximate to 862 subjects per general practice who should be screened, resulting in a time-requirement of approximately 6 weeks of full time work. Using an existing clinical prediction model, 247 patients per general practice should be screened for PAD by ABI measurement. Conclusion: Screening the entire population of >= 50 years will in our opinion not be feasible in general practice. A more rationale and efficient approach might be screening of subsets of the population of >= 55 years based on a clinical prediction model.
U2 - 10.1186/1471-2261-12-59
DO - 10.1186/1471-2261-12-59
M3 - Article
C2 - 22846150
SN - 1471-2261
VL - 12
SP - 59
JO - BMC Cardiovascular disorders
JF - BMC Cardiovascular disorders
ER -