Reliability of the Edinburgh Claudication Questionnaire for identifying symptomatic PAD in General Practice

L Boylan, C Nesbitt, L Wilson, John Allen, A Sims, I Guri, P Mawson, CP Oates, G Stansby

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    The Edinburgh Claudication Questionnaire (ECQ) was developed to help identify peripheral arterial disease (PAD) in the general population but has not been validated against diagnostic arterial imaging methods such as Duplex Vascular Ultrasound Scanning (DUS). In the present study, we assessed the accuracy of the ECQ for diagnosis using DUS. As part of a National Institute of Health Research funded project looking at novel diagnostic methods, 250 patients were studied from 15 general practices across North East England from May 2015 and November 2016. Practices identified those with a PAD diagnosis from their registers as well as age- and sex-matched controls. All the ECQs were recorded by a vascular specialist nurse. Duplex vascular ultrasound scanning was used as a reference standard for the diagnosis of occlusive PAD. The ECQ had a sensitivity of 52.5% (95% CI: 42.3%-62.5%), specificity of 87.1% (95% CI: 80.6%-92.0%), positive likelihood ratio of 4.06 (95% CI: 2.57-6.42), and negative likelihood ratio of 0.55 (95% CI: 0.44-0.68) compared with reference standard DUS. The ECQ has relatively poor overall diagnostic test accuracy in isolation. It may be helpful in ruling out PAD or as a supplementary test to improve diagnosis of symptomatic disease in General Practice.
    Original languageEnglish
    Pages (from-to)474-479
    Number of pages6
    Issue number5
    Early online date5 Jan 2021
    Publication statusPublished - May 2021

    Bibliographical note article is distributed under the terms of the Creative Commons Attribution 4.0 License ( which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (


    Funding Information:
    All our authors contributed to (1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, and (3) final approval of the version to be published. This report is independent research funded by the National Institute for Health Research (NIHR) (Invention for Innovation, “Innovative photoplethysmography technology for rapid non-invasive assessment of peripheral arterial disease in primary care”, II-C1-0412-20003). The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service (NHS), the National Institute for Health Research or the Department of Health and Social Care.

    Funding Information:
    The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: NIHR funded (ISRCTN13301188)

    Publisher Copyright:
    © The Author(s) 2021.


    • Edinburgh Claudication Questionnaire
    • peripheral arterial disease
    • primary care
    • screening

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine


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