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Universal Screening for Prevention of Reading, Writing, and Math Disabilities in Spanish
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PAD screening: why? whom? when? how? - a systematic review.

Arne G Kieback1, Roman Gähwiler1, Christoph Thalhammer1

  • 1Medical University Department, Division of Angiology, Kantonsspital Aarau, Aargau, Switzerland.

VASA. Zeitschrift Fur Gefasskrankheiten
|July 18, 2020
PubMed
Summary
This summary is machine-generated.

Peripheral arterial disease (PAD) screening lacks robust evidence, but a combined approach for abdominal aortic aneurysm (AAA) and hypertension in older men is supported. A new 3-step symptomatic PAD screening is proposed for individuals aged 40+.

Keywords:
Peripheral arterial diseaseankle-brachial indexclaudicationlower extremity arterial diseasescreeningsystematic review

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Area of Science:

  • Vascular Medicine
  • Public Health Screening

Background:

  • Peripheral arterial disease (PAD) affects 237 million globally, with increasing prevalence and significant morbidity/mortality.
  • Current PAD screening lacks randomized trials and established guidelines, with heterogeneous recommendations.
  • Ankle-brachial index (ABI) is a common screening tool but has limitations, especially in diabetic populations.

Purpose of the Study:

  • To systematically review current literature and guidelines on peripheral arterial disease (PAD) screening.
  • To evaluate the evidence base for PAD screening strategies.
  • To propose evidence-based screening recommendations for PAD.

Main Methods:

  • Systematic review of relevant literature and clinical guidelines.
  • Analysis of existing data on PAD screening effectiveness and limitations.
  • Evaluation of guideline recommendations regarding PAD screening.

Main Results:

  • Insufficient data exists to definitively support widespread PAD screening.
  • Guideline recommendations vary, with most advocating selective screening despite limited evidence of morbidity/mortality reduction.
  • The VIVA study provides evidence for combined screening of abdominal aortic aneurysm (AAA), PAD, and hypertension in men aged 65-74.

Conclusions:

  • The combined screening for AAA, PAD, and hypertension in men aged 65-74 is the only evidence-based strategy currently supported.
  • A new, simple three-step screening strategy for symptomatic PAD in individuals aged 40+ visiting a general practitioner is proposed.
  • This proposed strategy involves a symptom question, physical examination, and ABI measurement when indicated.