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Randomized Controlled Trial
. 2013 Oct;24(10):1427-35; quiz 1436.
doi: 10.1016/j.jvir.2013.05.057. Epub 2013 Jul 29.

Correlation of patient-reported symptom outcomes and treadmill test outcomes after treatment for aortoiliac claudication

Timothy P Murphy  1 , Matthew R Reynolds, David J Cohen, Judith G Regensteiner, Joseph M Massaro, Donald E Cutlip, Emile R Mohler, Joselyn Cerezo, Niki C Oldenburg, Claudia C Thum, Suzanne Goldberg, Alan T Hirsch
Affiliations
Randomized Controlled Trial

Correlation of patient-reported symptom outcomes and treadmill test outcomes after treatment for aortoiliac claudication

Timothy P Murphy et al. J Vasc Interv Radiol. 2013 Oct.

Abstract

Purpose: To examine the relationship between objective treadmill test outcomes and subjective symptom outcomes among patients with claudication treated with stent revascularization (ST) compared with supervised exercise (SE).

Materials and methods: Five scales of the Peripheral Artery Questionnaire and Walking Impairment Questionnaire were correlated with peak walking time and treadmill claudication onset time.

Results: The correlation between change in disease-specific quality of life (QOL) and change in peak walking time differed according to treatment group, with statistically significant correlations for all five scales for the ST group and weaker trends for the SE group, only one of which was statistically significant. In contrast, improvements in disease-specific QOL correlated well with increases in claudication onset time, with no significant interaction with treatment group for any of the five scales.

Conclusions: Disease-specific QOL results at 6 months in the Claudication: Exercise Vs. Endoluminal Revascularization (CLEVER) study show that improved maximal treadmill walking in patients with claudication treated with SE correlated poorly with self-reported symptom relief. Conversely, patients treated with ST showed good correlation between improved maximal treadmill walking and self-reported symptom improvement. The correlation between claudication onset time and self-reported symptom relief was good across treatment groups. This finding indicates that traditional objective treadmill test outcomes may not correlate well with symptom relief in patients with claudication. Future studies should investigate these data and improve understanding of patient relevance of traditional objective treadmill-based treatment outcomes.

Keywords: CLEVER; COT; Claudication: Exercise Vs. Endoluminal Revascularization; OMC; PAD; PAQ; PWT; Peripheral Artery Questionnaire; QOL; SE; ST; WIQ; Walking Impairment Questionnaire; claudication onset time; optimal medical care; peak walking time; peripheral artery disease; quality of life; stent revascularization; supervised exercise.

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Figures

Figure 1
Figure 1
(a–e) Scatterplots of the change in disease-specific QOL versus change in PWT. The change in PWT at 6 months compared with baseline is on the x-axis, and the change in the patient-reported symptom outcome scale at 6 months compared with baseline on the y-axis. These plots show considerable scatter of SE data points with no statistically significant correlation and little if any slope in the plotted line. Conversely, an increase in PWT in ST participants at 6 months correlated strongly with improved symptom scores.
Figure 2
Figure 2
(a–e) Scatterplots of the change in QOL versus change in COT. The change in COT at 6 months compared with baseline is on the x-axis, and the change in the patient-reported symptom outcome scale at 6 months compared with baseline is on the y-axis. These plots show better of SE data points compared with PWT, with statistically significant correlation and a positive slope for most scales. However, the correlation was stronger for ST participants.
See this image and copyright information in PMC

References

    1. Ouriel K. Peripheral arterial disease. Lancet. 2001;358:1257–1264. - PubMed
    1. Murphy TP, Soares GM, Kim HM, Ahn SH, Haas RA. Quality of life and exercise performance after aortoiliac stent placement for claudication. J Vasc Interv Radiol. 2005;16:947–953. quiz 954. - PubMed
    1. Mahoney EM, Wang K, Keo HH, et al. Vascular hospitalization rates and costs in patients with peripheral artery disease in the United States. Circ Cardiovasc Qual Outcomes. 2010;3:642–651. - PubMed
    1. Anonymous [August 9, 2012];100 initial priority topics for comparative effectiveness research. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2009/ComparativeEffectiv....
    1. Hiatt WR, Hirsch AT, Regensteiner JG, Brass EP. Clinical trials for claudication. Assessment of exercise performance, functional status, and clinical end points. Vascular Clinical Trialists. Circulation. 1995;92:614–621. - PubMed

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