title: Correlation of patient-reported symptom outcomes and treadmill test outcomes after treatment for aortoiliac claudication.
abstract: OBJECTIVE
  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).
  
  
  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.
authors.affiliation: Department of Diagnostic Imaging, Vascular Disease Research Center, Rhode Island Hospital, Gerry 337, 593 Eddy Street, Providence, RI 02903. Electronic address: tmurphy@lifespan.org.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Murphy
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Reynolds
authors.forename: David J
authors.initials: DJ
authors.lastname: Cohen
authors.forename: Judith G
authors.initials: JG
authors.lastname: Regensteiner
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.forename: Donald E
authors.initials: DE
authors.lastname: Cutlip
authors.forename: Emile R
authors.initials: ER
authors.lastname: Mohler
authors.forename: Joselyn
authors.initials: J
authors.lastname: Cerezo
authors.forename: Niki C
authors.initials: NC
authors.lastname: Oldenburg
authors.forename: Claudia C
authors.initials: CC
authors.lastname: Thum
authors.forename: Suzanne
authors.initials: S
authors.lastname: Goldberg
authors.forename: Alan T
authors.initials: AT
authors.lastname: Hirsch
mesh_terms: D001807:Blood Vessel Prosthesis / Q000706:statistics & numerical data; D059026:Diagnostic Self Evaluation; D005080:Exercise Test / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D015995:Prevalence; D011788:Quality of Life; D020127:Recovery of Function; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013223:Statistics as Topic; D015607:Stents / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
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
references.citation: J Vasc Surg. 1997 Feb;25(2):312-8; discussion 318-9
references.pmid: 9052565
references.citation: Vasa. 2002 Feb;31(1):29-34
references.pmid: 11951695
references.citation: J Vasc Surg. 1996 Jan;23(1):104-15
references.pmid: 8558725
references.citation: Eur J Vasc Endovasc Surg. 1996 Aug;12(2):167-72
references.pmid: 8760978
references.citation: Circ Cardiovasc Qual Outcomes. 2010 Nov;3(6):642-51
references.pmid: 20940249
references.citation: Eur J Vasc Endovasc Surg. 2011 Aug;42(2):220-7
references.pmid: 21397530
references.citation: Circulation. 1995 Aug 1;92(3):614-21
references.pmid: 7634476
references.citation: Cardiovasc Surg. 1997 Aug;5(4):424-6
references.pmid: 9350800
references.citation: J Vasc Interv Radiol. 2005 Jul;16(7):947-53; quiz 954
references.pmid: 16002502
references.citation: J Sports Med Phys Fitness. 1990 Sep;30(3):268-75
references.pmid: 2266758
references.citation: Radiology. 2009 Feb;250(2):586-95
references.pmid: 19188327
references.citation: N Engl J Med. 1979 Jun 21;300(25):1424-9
references.pmid: 35750
references.citation: Radiology. 2005 Jun;235(3):833-42
references.pmid: 15860674
references.citation: J Vasc Surg. 2009 Aug;50(2):322-9
references.pmid: 19631868
references.citation: Circulation. 2007 Feb 6;115(5):569-75
references.pmid: 17242281
references.citation: Circulation. 2012 Jan 3;125(1):130-9
references.pmid: 22090168
references.citation: Qual Life Res. 2000;9(6):591-601
references.pmid: 11236850
references.citation: J Vasc Surg. 2008 Jun;47(6):1356-63
references.pmid: 18440181
references.citation: Am Heart J. 2004 Feb;147(2):301-8
references.pmid: 14760329
references.citation: Scott Med J. 1997 Apr;42(2):47-8
references.pmid: 9507581
references.citation: Vasc Med. 2009 Nov;14(4):313-21
references.pmid: 19808716
references.citation: Lancet. 2001 Oct 13;358(9289):1257-64
references.pmid: 11675083
references.citation: Med Sci Sports Exerc. 1991 Apr;23(4):402-8
references.pmid: 2056896
references.citation: Ann Vasc Surg. 1999 Jan;13(1):93-103
references.pmid: 9878663
references.citation: Eur J Vasc Endovasc Surg. 2001 Aug;22(2):114-23
references.pmid: 11472043