Spertus John, Jones Philip, Poler Sherri, Rocha-Singh Krishna
Mid America Heart Institute of Saint Luke's Hospital and the University of Missouri-Kansas City, Kansas City, Mo, USA.
Am Heart J. 2004 Feb;147(2):301-8. doi: 10.1016/j.ahj.2003.08.001.
The most common indication for treating patients with peripheral arterial disease is to improve their health status: their symptoms, function, and quality of life. Quantifying health status requires a valid, reproducible, and sensitive disease-specific measure. The Peripheral Artery Questionnaire (PAQ) is a 20-item questionnaire developed to meet this need by quantifying patients' physical limitations, symptoms, social function, treatment satisfaction, and quality of life.
Psychometric and clinical properties of the PAQ were evaluated in a prospective cohort study of 44 patients undergoing elective percutaneous peripheral revascularization. To establish reproducibility, 2 assessments were performed 2 weeks apart and before revascularization. The change in scores before and 6 weeks after revascularization were used to determine the instruments' responsiveness and were compared with the Short Form-36 and the Walking Impairment Questionnaire. A series of cross-sectional analyses were performed to establish the construct validity of the PAQ.
The 7 domains of the PAQ were internally reliable, with Cronbach alpha = 0.80 to 0.94. The test-retest reliability analyses revealed insignificant mean changes of 0.6 to 2.3 points (P = not significant for all). Conversely, the change after revascularization ranged from 13.7 to 41.9 points (P < or =.001 for all), reflecting substantial sensitivity of the PAQ to clinical improvement. The PAQ Summary Scale was the most sensitive of all scales tested. Construct validity was established by demonstrating correlations with other measures of patient health status.
The PAQ is a valid, reliable, and responsive disease-specific measure for patients with peripheral arterial disease. It may prove to be a useful end point in clinical trials and a potential aid in disease management.
治疗外周动脉疾病患者最常见的指征是改善其健康状况，包括症状、功能和生活质量。量化健康状况需要一种有效、可重复且敏感的疾病特异性测量方法。外周动脉问卷（PAQ）是一份包含20个条目的问卷，旨在通过量化患者的身体限制、症状、社会功能、治疗满意度和生活质量来满足这一需求。
在一项对44例行择期经皮外周血管重建术患者的前瞻性队列研究中评估了PAQ的心理测量学和临床特性。为确定可重复性，在血管重建术前2周进行了2次评估，每次评估间隔2周。血管重建术前和术后6周的得分变化用于确定该工具的反应性，并与简明健康状况调查问卷（Short Form-36）和步行障碍问卷进行比较。进行了一系列横断面分析以确定PAQ的结构效度。
PAQ的7个领域具有内部可靠性，克朗巴哈系数（Cronbach alpha）为0.80至0.94。重测信度分析显示平均变化不显著，为0.6至2.3分（所有P值均无统计学意义）。相反，血管重建术后的变化范围为13.7至41.9分（所有P≤0.001），反映出PAQ对临床改善具有高度敏感性。PAQ总结量表是所有测试量表中最敏感的。通过证明与患者健康状况的其他测量方法的相关性来确定结构效度。
PAQ是一种用于外周动脉疾病患者的有效、可靠且反应灵敏的疾病特异性测量方法。它可能被证明是临床试验中一个有用的终点指标，并且在疾病管理中具有潜在的辅助作用。
