Key result
Using a clinical prediction model reduces the number of patients needing ankle-brachial index screening for peripheral arterial disease to 247 per general practice, compared to 862 patients with universal screening of adults aged 50 and older.
Why the study?
Is screening with ankle-brachial index (ABI) measurement feasible in general practice for subjects ≥55 years with vascular risk factors or claudication symptoms?
Observational (n=13,038)
Yes
Is screening with ankle-brachial index (ABI) measurement feasible in general practice for subjects ≥55 years with vascular risk factors or claudication symptoms?
Universal ABI screening in general practice is not feasible due to time constraints, but targeted screening using a clinical prediction model may be more efficient.
Answers are grounded in this paper and cite their sources.
Targeted ABI screening with a prediction model may enhance feasibility in general practice; supports prospective validation before adoption.
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 ≈ 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.
No takes yet. Share an insight, caveat, or question.
Bendermacher et al. (2012) conducted an observational in High cardiovascular risk / Asymptomatic peripheral arterial disease (n=13,038). Ankle-brachial index (ABI) screening based on clinical prediction model vs. Universal ABI screening for age ≥50 years was evaluated on Number of patients needed to screen per general practice. Using a clinical prediction model reduces the number of patients needing ankle-brachial index screening for peripheral arterial disease to 247 per general practice, compared to 862 patients with universal screening of adults aged 50 and older.
Synapse has enriched 10 related papers. Consider them for comparative context: