Performance of physical examination versus ultrasonography to detect stenosis in haemodialysis arteriovenous fistula.
OBJECTIVE
The overall purpose of this study is to compare the accuracy of physical examination (PE) versus ultrasonography (US) in people with arteriovenous fistula (AVF).


METHODS
This is a cross-sectional study with a total of 99 patients attended by the vascular radiology unit for AVF evaluation during January - March 2015. PE and ultrasonography were blinded performed by different radiologists. For complete and individual signs of PE, sensitivity, specificity, predictive positive (PPV) and negative (PNV) value, likelihood ratios (LR) and Cohen's κ value were measured.


RESULTS
According to ultrasonography, the presence of stenosis was identified in 57 (58%) patients, and 61 (62%) by PE. The accuracy of PE for the diagnosis of AVF was sensitivity 82%, specificity 67%, PPV 77%, NPV 74%, LR 2.74 and 0.26. There was a moderate agreement beyond chance between PE and ultrasonography (κ = 0.5).


CONCLUSIONS
PE has shown a moderate accuracy to detect stenosis. With non-ultrasonography availability Haemodialysis Units can get benefit to optimize VA survival and professionals should improve its basic skills.
Department of Preventive Medicine, "Reina Sofia" University General Hospital, Murcia - Spain.|Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, IMIB-Arrixaca - Spain.
Ana B
AB
Maldonado-Cárceles
Department of Vascular and Interventional Radiology, "Reina Sofia" University General Hospital, Murcia - Spain.
José
J
García-Medina
Department of Preventive Medicine, "Reina Sofia" University General Hospital, Murcia - Spain.|Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, IMIB-Arrixaca - Spain.
Alberto M
AM
Torres-Cantero
D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D003251:Constriction, Pathologic; D003430:Cross-Sectional Studies; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D006435:Renal Dialysis; D014463:Ultrasonography; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency