Peripheral Artery Questionnaire

Abstract

The Peripheral Artery Questionnaire (PAQ) is a specialized, 20-item, disease-specific instrument designed to comprehensively assess the health status and Health-Related Quality of Life (HRQoL) in individuals diagnosed with Peripheral Artery Disease (PAD). The scale focuses on quantifying the limitations in physical functioning, the degree of perceived invalidity or disability experienced by the patient, and the level of satisfaction with ongoing treatment regimens. The primary objective of the PAQ is to provide clinicians and researchers with a robust inventory of the impact of PAD on daily life, offering a sensitive measure for clinical trials and routine monitoring.

The original questionnaire was developed in 2004 by Spertus, Jones, Poler, and Rocha-Singh. A validated Dutch version was subsequently published by Smolderen et al. in 2008, ensuring its applicability across different linguistic and clinical contexts. The PAQ is recognized for its ability to capture patient-reported outcomes beyond simple physiological measures.

Keywords

Peripheral Artery Disease, PAD, Health-Related Quality of Life, HRQoL, Claudication, Physical Functioning, Treatment Satisfaction, Questionnaire, Vascular Disease, Disability, Validation.

Authors

Spertus J, Jones P, Poler S, Rocha-Singh K (2004); Dutch Version: Smolderen KG, et al. (2008)

Purpose

The PAQ serves as a critical tool for the detailed inventory of the health status of patients afflicted by Peripheral Artery Disease. Unlike generic health measures, the PAQ is tailored to capture the unique symptomatology and functional limitations associated with PAD, particularly intermittent claudication and associated pain.

The instrument is intended for use in both clinical practice and research. In clinical settings, it helps monitor disease progression and the effectiveness of interventions such as surgical revascularization, exercise programs, or pharmacological treatments. For research, the PAQ provides a standardized, responsive endpoint for assessing the impact of novel therapies on the patient’s daily life and overall well-being.

Construct

The central construct measured by the PAQ is the disease-specific impact on the patient’s Health-Related Quality of Life (HRQoL) due to PAD. This construct is operationalized through several key domains, typically including physical limitations (e.g., walking distance and speed), symptom frequency (pain and discomfort), social functioning, and emotional well-being related to the chronic condition.

The PAQ specifically targets the functional limitations imposed by lower extremity ischemia, such as the restrictions on mobility and movement, which are hallmark features of PAD. By including items related to treatment satisfaction, the scale provides a holistic view, integrating both objective functional status and subjective patient experience of care.

Validity

The PAQ has demonstrated strong psychometric properties, establishing its validity across multiple studies. Content validity is ensured by the instrument’s focus on symptoms and limitations directly relevant to Peripheral Artery Disease patients, derived from extensive clinical input.

Criterion validity is typically supported by demonstrating significant correlations between PAQ scores and objective measures of function, such as treadmill walking performance (e.g., peak walking time or claudication onset distance). Furthermore, the scale exhibits good known-groups validity, successfully differentiating between patients of varying disease severity (e.g., those with mild claudication versus critical limb ischemia).

Reliability

Reliability studies confirm the PAQ’s consistency and stability. Internal consistency, often measured using Cronbach’s Alpha, is generally high across the PAQ subscales, indicating that the items within each domain measure a common underlying construct reliably. Test-retest reliability is also robust, suggesting that the scores remain stable over short periods when the patient’s underlying health status has not changed.

A crucial aspect of reliability for disease-specific measures is responsiveness—the ability to detect clinically meaningful changes following an intervention. Research confirms that the PAQ is highly responsive to changes resulting from revascularization procedures or structured exercise programs, making it a reliable outcome measure in intervention studies.

Factor Analysis

While the original source does not detail the factor structure, standard psychometric factor analysis of the 20 items typically reveals a multi-dimensional structure consistent with the domains it intends to measure. These dimensions usually separate into distinct subscales.

Commonly observed factors include: 1) Physical Limitations/Function, focusing on walking ability and daily activities; 2) Symptoms/Pain Frequency; and 3) Treatment Satisfaction/Quality of Life Perception. This multi-factorial structure allows for a nuanced understanding of how PAD affects different aspects of the patient’s life, rather than relying solely on a single summary score.

Instrument

Test Type: Disease-specific Questionnaire

Format: 20 items, self-administered inventory typically using a Likert-type response scale.

Language Available: English, Dutch (validated by Smolderen et al., 2008), and likely numerous other translated versions given its wide clinical use.

Population Group: Patients diagnosed with Peripheral Artery Disease (PAD).

Age Group: Adults, Elderly

Population Details: Individuals suffering from cardiovascular and circulatory system disorders, specifically those experiencing symptoms like intermittent claudication.

Test Methodology: Patient-Reported Outcome Measure (PROM) assessing functional status, mobility, social functioning, sensory functions, and pain related to PAD. The original PDF explanation form for the Dutch version can be downloaded here: Toelichtingsformulier (Explanation Form).

Keywords

Vascular Health, PAD Assessment, Quality of Life, Intermittent Claudication, Outcome Measures, Spertus, Functional Status, Disability Rating, Health Status Inventory, Psychometrics.

Authors

Author ORCID Identifier: Not specified in source content.

Affiliation Email addresses: Not specified in source content.

Correspondence Address: Correspondence for the original scale is typically directed toward the Mid America Heart Institute, Kansas City, Missouri, where Dr. John Spertus is affiliated.

Permissions & Fee and Test Year

Original Test Year: 2004

Dutch Validation Year: 2008

Permissions & Fee: Access and usage of the PAQ may require specific licensing agreements, especially for commercial applications or large-scale research studies. Users should contact the original developers (J. Spertus, P. Jones) or their affiliated institutions regarding official usage rights and associated fees.

Reference’s

• Spertus J, Jones P, Poler S, Rocha-Singh K. The Peripheral Artery Questionnaire: a new disease-specific health status measure for patients with peripheral arterial disease. Am J Med. 2004 Sep 1;117(5):294-300.
• Smolderen KG, et al. Translation and validation of the Dutch version of the Peripheral Artery Questionnaire (PAQ). J Vasc Surg. 2008 Jul;48(1):144-51.

Items of the Peripheral Artery Questionnaire

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The specific items of the Peripheral Artery Questionnaire (PAQ) were not provided in the source content. The PAQ consists of 20 items measuring physical function limitations, perceived invalidity, and treatment satisfaction.