文档介绍：Early Identification of PAD: Evidence to Refute USPSTF Position on Screening MehdiH. Shishehbor, DO, MPH, PhD Director Endovascular Services Interventional Cardiology & Vascular Medicine Department of Cardiovascular Medicine Cleveland Clinic Disclosure Information NONE Every Patient Should Have an ABI Test… Or should they? ?The USPSTF mends againstroutinescreening for peripheral arterial disease (PAD) ?On what basis? Screening for PAD among asymptomatic adults in the general population would have few or no benefits because: ?the prevalence of PAD in this group is low(!!) ?there is little evidence that treatment of PAD at this asymptomatic stage of disease improves health es. ?screening asymptomatic adults with the ABI could lead to some small degree of harm, including false-positive results and unnecessary work-ups . Preventive Services Task Force: Who Should Have an ABI Test? . Preventive Services Task Force. Screening for Peripheral Arterial Disease: mendation Statement. 2015. nic/uspstf05/pad/. No onewithout symptoms ! ACC/AHA Consensus Guidelines: Who should have an ABI test? Class I mendation: The resting ABI should be used to establish the lower extremity PAD diagnosis in patients with: ?Exertional leg symptoms ?Non-healing wounds ?Asymptomatic patients at high risk ?Adults >70 years of age ?Adults >50 years of age with diabetes or o use Hirsch, AT, et al. ACC/AHA Guidelines for the Management of Patients with PAD. 2005. “Due to the high estimated prevalence of PAD in patients with diabetes, a screening ABI should be performed in patients > 50 years of age who have diabetes. If normal, the test should be repeated every 5 years.”“A screening ABI should be considered in diabetic patients < 50 years of age who have other PAD risk factors.” American Diabetes Association Consensus Statement. Diabetes Care2003; 12:3333. ADA Consensus Guidelines: Who should have an ABI test? NHANES 1999-2000 Survey Selvin, E. et al. Circulati