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Published on: February 8, 2019
Can the scoring of the walking estimated limitation calculated by history (WELCH) questionnaire be simultaneously
Clement Bourdois1, Isabelle Laporte1, Raphael Godet1
1University Hospital, Angers, France.
Insights
The WELCH questionnaire estimates maximal walking time in claudication patients. Testing alternative scoring methods showed the original empirical approach offers the best balance of accuracy and simplicity.
Area of Science:
- Vascular Medicine
- Clinical Assessment Tools
- Biostatistics
Background:
- The WELCH questionnaire assesses maximal walking time (MWT) in patients with claudication.
- Its current scoring method was empirically derived.
- The study aimed to evaluate alternative scoring methods for the WELCH questionnaire.
Purpose of the Study:
- To determine if alternative scoring methods can improve or simplify the WELCH questionnaire.
- To compare the accuracy and simplicity of various scoring algorithms against the established empirical method.
Main Methods:
- 423 patients with claudication were analyzed.
- Eight different scoring methods were tested, involving adjustments to the weighting of questionnaire items (A, B, C, D) and coefficients (α, β, γ) in the MWT equation.
- Statistical analysis included Pearson correlation and ROC curve analysis.
Main Results:
- The reference empirical method yielded a Pearson r of 0.639 and an area under the ROC curve (AUC) of 0.795 for predicting 5-minute treadmill walking ability.
- Alternative methods showed Pearson r values ranging from 0.566 to 0.661 and AUCs from 0.750 to 0.809.
- No single tested method consistently outperformed the original scoring in both accuracy and simplicity.
Conclusions:
- The original empirical scoring of the WELCH questionnaire represents a practical balance between predictive accuracy and ease of use.
- Alternative scoring methods did not offer a significant advantage in improving MWT correlation while maintaining simplicity.
- The established scoring method remains a reliable tool for estimating MWT in claudication patients.
Background:
The WELCH questionnaire includes 4 items (A, B, C and D) and estimates the maximal walking time (MWT) on treadmill in patients with claudication. Its scoring was empirically defined. We aimed to test various methods for scoring to estimate whether the scoring of the WELCH could be improved or simplified.
Patients And Methods:
In 423 patients, we tested 8 methods (from H1 to H8) of weighing D or calculating α, β and γ in the equation MWT = (αA + βB + γC) * D.
Results:
While the WELCH Pearson r was 0.639 and area under ROC curve for the ability to walk 5 minutes on treadmill was 0.795 for the reference empirical method, tested hypotheses resulted in values ranging 0.566 to 0.661 for the Pearson r values and 0.750 to 0.809 for the areas under ROC curve respectively.
Conclusions:
None of the tested methods simultaneously improved the correlation to MWT, remained simple enough to be scored by mental calculation and ranged between intuitive minimal and maximal values. The original empirical scoring seems a good compromise between accuracy and simplicity.
