Links to Exploration step
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Reliability and Feasibility of Methods to Quantitatively Assess Peripheral Edema</title><author><name sortKey="Brodovicz, Kimberly G" sort="Brodovicz, Kimberly G" uniqKey="Brodovicz K" first="Kimberly G." last="Brodovicz">Kimberly G. Brodovicz</name><affiliation><nlm:aff id="aff1">Kimberly G. Brodovicz, DrPH, Department of Epidemiology, Merck Research Laboratories, North Wales, Pennsylvania</nlm:aff></affiliation></author><author><name sortKey="Mcnaughton, Kristin" sort="Mcnaughton, Kristin" uniqKey="Mcnaughton K" first="Kristin" last="Mcnaughton">Kristin Mcnaughton</name><affiliation><nlm:aff id="aff2">Kristin McNaughton, MHS, Department of Epidemiology, Merck Research Laboratories, North Wales, Pennsylvania</nlm:aff></affiliation></author><author><name sortKey="Uemura, Naoto" sort="Uemura, Naoto" uniqKey="Uemura N" first="Naoto" last="Uemura">Naoto Uemura</name><affiliation><nlm:aff id="aff3">Naoto Uemura, MD, Department of Clinical Research–Clinical Pharmacology, Merck Research Laboratories, Rahway, New Jersey</nlm:aff></affiliation></author><author><name sortKey="Meininger, Gary" sort="Meininger, Gary" uniqKey="Meininger G" first="Gary" last="Meininger">Gary Meininger</name><affiliation><nlm:aff id="aff4">Gary Meininger, MD, Department of Clinical Research–Metabolism, Merck Research Laboratories, Rahway, New Jersey</nlm:aff></affiliation></author><author><name sortKey="Girman, Cynthia J" sort="Girman, Cynthia J" uniqKey="Girman C" first="Cynthia J." last="Girman">Cynthia J. Girman</name><affiliation><nlm:aff id="aff5">Cynthia J. Girman, DrPH, Department of Epidemiology, Merck Research Laboratories, North Wales, Pennsylvania</nlm:aff></affiliation></author><author><name sortKey="Yale, Steven H" sort="Yale, Steven H" uniqKey="Yale S" first="Steven H." last="Yale">Steven H. Yale</name><affiliation><nlm:aff id="aff6">Steven H. Yale, MD, Department of Internal Medicine, Marshfield Clinic and Clinical Research Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19251582</idno><idno type="pmc">2705274</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2705274</idno><idno type="RBID">PMC:2705274</idno><idno type="doi">10.3121/cmr.2009.819</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">001747</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001747</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Reliability and Feasibility of Methods to Quantitatively Assess Peripheral Edema</title><author><name sortKey="Brodovicz, Kimberly G" sort="Brodovicz, Kimberly G" uniqKey="Brodovicz K" first="Kimberly G." last="Brodovicz">Kimberly G. Brodovicz</name><affiliation><nlm:aff id="aff1">Kimberly G. Brodovicz, DrPH, Department of Epidemiology, Merck Research Laboratories, North Wales, Pennsylvania</nlm:aff></affiliation></author><author><name sortKey="Mcnaughton, Kristin" sort="Mcnaughton, Kristin" uniqKey="Mcnaughton K" first="Kristin" last="Mcnaughton">Kristin Mcnaughton</name><affiliation><nlm:aff id="aff2">Kristin McNaughton, MHS, Department of Epidemiology, Merck Research Laboratories, North Wales, Pennsylvania</nlm:aff></affiliation></author><author><name sortKey="Uemura, Naoto" sort="Uemura, Naoto" uniqKey="Uemura N" first="Naoto" last="Uemura">Naoto Uemura</name><affiliation><nlm:aff id="aff3">Naoto Uemura, MD, Department of Clinical Research–Clinical Pharmacology, Merck Research Laboratories, Rahway, New Jersey</nlm:aff></affiliation></author><author><name sortKey="Meininger, Gary" sort="Meininger, Gary" uniqKey="Meininger G" first="Gary" last="Meininger">Gary Meininger</name><affiliation><nlm:aff id="aff4">Gary Meininger, MD, Department of Clinical Research–Metabolism, Merck Research Laboratories, Rahway, New Jersey</nlm:aff></affiliation></author><author><name sortKey="Girman, Cynthia J" sort="Girman, Cynthia J" uniqKey="Girman C" first="Cynthia J." last="Girman">Cynthia J. Girman</name><affiliation><nlm:aff id="aff5">Cynthia J. Girman, DrPH, Department of Epidemiology, Merck Research Laboratories, North Wales, Pennsylvania</nlm:aff></affiliation></author><author><name sortKey="Yale, Steven H" sort="Yale, Steven H" uniqKey="Yale S" first="Steven H." last="Yale">Steven H. Yale</name><affiliation><nlm:aff id="aff6">Steven H. Yale, MD, Department of Internal Medicine, Marshfield Clinic and Clinical Research Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin</nlm:aff></affiliation></author></analytic><series><title level="j">Clinical Medicine & Research</title><idno type="ISSN">1539-4182</idno><idno type="eISSN">1554-6179</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold><italic>Objective:</italic></bold> To evaluate methods to assess peripheral edema for reliability, feasibility and correlation with the classic clinical assessment of pitting edema.</p><p><bold><italic>Design:</italic></bold> Cross-sectional observational study.</p><p><bold><italic>Setting:</italic></bold> Large primary care clinic in Marshfield, Wisconsin, USA.</p><p><bold><italic>Participants:</italic></bold> Convenience sample of 20 patients with type 2 diabetes and a range of edema severity, including patients without edema.</p><p><bold><italic>Methods:</italic></bold> Eight methods of edema assessment were evaluated: (1) clinical assessment of pit depth and recovery at three locations, (2) patient questionnaire, (3) ankle circumference, (4) figure-of-eight (ankle circumference using eight ankle/foot landmarks), (5) edema tester (plastic card with holes of varying size pressed to the ankle with a blood pressure cuff), (6) modified edema tester (edema tester with bumps), (7) indirect leg volume (by series of ankle/leg circumferences), and (8) foot/ankle volumetry by water displacement. Patients were evaluated independently by three nurse examiners.</p><p><bold><italic>Results:</italic></bold> Water displacement and ankle circumference had high inter-examiner agreement (intraclass correlation coefficient 0.93, 0.96 right; 0.97, 0.97 left). Agreement was inconsistent for figure-of-eight (0.64, 0.86), moderate for indirect leg volume (0.53, 0.66), and low for clinical assessments at all locations. Agreement was low for the edema testers but varied by the pressure administered. Correlation with the classic, subjective clinical assessment was good for the nurse-performed assessments and patient questionnaire. Ankle circumference and patient questionnaires each took 1 minute to complete. Other tools took >5 minutes to complete.</p><p><bold><italic>Conclusions:</italic></bold> Water displacement and ankle circumference showed excellent reliability; however, water displacement is a time-consuming measure and may pose implementation challenges in the clinical and clinical trial environments. Patient-reported level and frequency of edema, based on an unvalidated questionnaire, was generally well correlated with the physician assessment of edema severity and may prove to be another reliable and accurate method of assessing edema. Additional study is needed to evaluate the validity and responsiveness of these methods.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Med Res</journal-id><journal-id journal-id-type="publisher-id">clinmedres</journal-id><journal-title>Clinical Medicine & Research</journal-title><issn pub-type="ppub">1539-4182</issn><issn pub-type="epub">1554-6179</issn><publisher><publisher-name>Marshfield Clinic</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">19251582</article-id><article-id pub-id-type="pmc">2705274</article-id><article-id pub-id-type="publisher-id">0070021</article-id><article-id pub-id-type="doi">10.3121/cmr.2009.819</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Research</subject></subj-group></article-categories><title-group><article-title>Reliability and Feasibility of Methods to Quantitatively Assess Peripheral Edema</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Brodovicz</surname><given-names>Kimberly G.</given-names></name><degrees>DrPH</degrees><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>McNaughton</surname><given-names>Kristin</given-names></name><degrees>MHS</degrees><xref ref-type="aff" rid="aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Uemura</surname><given-names>Naoto</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Meininger</surname><given-names>Gary</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="aff4"></xref></contrib><contrib contrib-type="author"><name><surname>Girman</surname><given-names>Cynthia J.</given-names></name><degrees>DrPH</degrees><xref ref-type="aff" rid="aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Yale</surname><given-names>Steven H.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="aff6"></xref></contrib></contrib-group><aff id="aff1">Kimberly G. Brodovicz, DrPH, Department of Epidemiology, Merck Research Laboratories, North Wales, Pennsylvania</aff><aff id="aff2">Kristin McNaughton, MHS, Department of Epidemiology, Merck Research Laboratories, North Wales, Pennsylvania</aff><aff id="aff3">Naoto Uemura, MD, Department of Clinical Research–Clinical Pharmacology, Merck Research Laboratories, Rahway, New Jersey</aff><aff id="aff4">Gary Meininger, MD, Department of Clinical Research–Metabolism, Merck Research Laboratories, Rahway, New Jersey</aff><aff id="aff5">Cynthia J. Girman, DrPH, Department of Epidemiology, Merck Research Laboratories, North Wales, Pennsylvania</aff><aff id="aff6">Steven H. Yale, MD, Department of Internal Medicine, Marshfield Clinic and Clinical Research Center, Marshfield Clinic Research Foundation, Marshfield, Wisconsin</aff><author-notes><fn><p><bold>Reprint Requests:</bold> Kimberly G. Brodovicz, DrPH, Department of Epidemiology, Merck Research Laboratories, PO Box 1000, UG1D-60, North Wales, PA 19454, Tel: 267-305-7490, Fax: 215-616-2042, Email: <email>kimberly_brodovicz@merck.com</email></p></fn></author-notes><pub-date pub-type="ppub"><month>6</month><year>2009</year></pub-date><volume>7</volume><issue>1-2</issue><fpage>21</fpage><lpage>31</lpage><history><date date-type="received"><day>27</day><month>8</month><year>2008</year></date><date date-type="rev-recd"><day>2</day><month>12</month><year>2008</year></date><date date-type="accepted"><day>17</day><month>12</month><year>2008</year></date></history><permissions><copyright-statement>© 2009. Clinical Medicine & Research</copyright-statement></permissions><self-uri xlink:title="pdf" xlink:href="21.pdf"></self-uri><abstract><p><bold><italic>Objective:</italic></bold> To evaluate methods to assess peripheral edema for reliability, feasibility and correlation with the classic clinical assessment of pitting edema.</p><p><bold><italic>Design:</italic></bold> Cross-sectional observational study.</p><p><bold><italic>Setting:</italic></bold> Large primary care clinic in Marshfield, Wisconsin, USA.</p><p><bold><italic>Participants:</italic></bold> Convenience sample of 20 patients with type 2 diabetes and a range of edema severity, including patients without edema.</p><p><bold><italic>Methods:</italic></bold> Eight methods of edema assessment were evaluated: (1) clinical assessment of pit depth and recovery at three locations, (2) patient questionnaire, (3) ankle circumference, (4) figure-of-eight (ankle circumference using eight ankle/foot landmarks), (5) edema tester (plastic card with holes of varying size pressed to the ankle with a blood pressure cuff), (6) modified edema tester (edema tester with bumps), (7) indirect leg volume (by series of ankle/leg circumferences), and (8) foot/ankle volumetry by water displacement. Patients were evaluated independently by three nurse examiners.</p><p><bold><italic>Results:</italic></bold> Water displacement and ankle circumference had high inter-examiner agreement (intraclass correlation coefficient 0.93, 0.96 right; 0.97, 0.97 left). Agreement was inconsistent for figure-of-eight (0.64, 0.86), moderate for indirect leg volume (0.53, 0.66), and low for clinical assessments at all locations. Agreement was low for the edema testers but varied by the pressure administered. Correlation with the classic, subjective clinical assessment was good for the nurse-performed assessments and patient questionnaire. Ankle circumference and patient questionnaires each took 1 minute to complete. Other tools took >5 minutes to complete.</p><p><bold><italic>Conclusions:</italic></bold> Water displacement and ankle circumference showed excellent reliability; however, water displacement is a time-consuming measure and may pose implementation challenges in the clinical and clinical trial environments. Patient-reported level and frequency of edema, based on an unvalidated questionnaire, was generally well correlated with the physician assessment of edema severity and may prove to be another reliable and accurate method of assessing edema. Additional study is needed to evaluate the validity and responsiveness of these methods.</p></abstract><kwd-group><kwd>Measurement</kwd><kwd>Peripheral edema</kwd><kwd>Reliability</kwd></kwd-group></article-meta><notes><fn-group><fn><p><bold>Research Support:</bold> Fully supported by Merck & Co., Inc. SH Yale has received grant support from Merck & Co., Inc. and has been a consultant to and a clinical investigator for the company.</p></fn></fn-group></notes></front><floats-wrap><table-wrap position="float" id="t1"><label>Table 1.</label><caption><p>Demographic and clinical characteristics (n=20).</p></caption><table frame="hsides" rules="groups"><thead><tr><td align="left" rowspan="1"></td><td align="center" rowspan="1"><bold>Number of patients (%)</bold></td></tr></thead><tbody align="left"><tr valign="top"><td align="left" colspan="2" rowspan="1">Severity of edema*</td></tr><tr valign="top"><td align="left" rowspan="1"> None</td><td align="center" rowspan="1">4 (20)<sup>†</sup></td></tr><tr valign="top"><td align="left" rowspan="1"> Mild</td><td align="center" rowspan="1">10 (50)</td></tr><tr valign="top"><td align="left" rowspan="1"> Moderate</td><td align="center" rowspan="1">3 (15)</td></tr><tr valign="top"><td align="left" rowspan="1"> Severe</td><td align="center" rowspan="1">3 (15)</td></tr><tr valign="top"><td align="left" colspan="2" rowspan="1">Type of edema</td></tr><tr valign="top"><td align="left" rowspan="1"> Venous stasis</td><td align="center" rowspan="1">10 (50)</td></tr><tr valign="top"><td align="left" rowspan="1"> Lipedema<sup>‡</sup></td><td align="center" rowspan="1">4 (20)</td></tr><tr valign="top"><td align="left" rowspan="1"> Lymphedema</td><td align="center" rowspan="1">1 (5)</td></tr><tr valign="top"><td align="left" rowspan="1"> Two or more</td><td align="center" rowspan="1">2 (10)</td></tr><tr valign="top"><td align="left" rowspan="1"> None</td><td align="center" rowspan="1">3 (15)</td></tr><tr valign="top"><td align="left" rowspan="1">Mean age, years (range)</td><td align="center" rowspan="1">70.2 (59 to 85)</td></tr><tr valign="top"><td align="left" rowspan="1">Gender, women</td><td align="center" rowspan="1">14 (70)</td></tr><tr valign="top"><td align="left" rowspan="1">Race, white</td><td align="center" rowspan="1">20 (100)</td></tr><tr valign="top"><td align="left" rowspan="1">Mean weight, kg (range)</td><td align="center" rowspan="1">91.8 (59.4 to 133.4)</td></tr><tr valign="top"><td align="left" rowspan="1">Mean body mass index (kg/m<sup>2</sup> )</td><td align="center" rowspan="1">33.1 (20.8 to 45.8)</td></tr><tr valign="top"><td align="left" colspan="2" rowspan="1">Concurrent conditions</td></tr><tr valign="top"><td align="left" rowspan="1"> Hypertension</td><td align="center" rowspan="1">17 (85)</td></tr><tr valign="top"><td align="left" rowspan="1"> Dyslipidemia/hyperlipidemia</td><td align="center" rowspan="1">17 (85)</td></tr><tr valign="top"><td align="left" rowspan="1"> Coronary artery disease</td><td align="center" rowspan="1">6 (30)</td></tr><tr valign="top"><td align="left" rowspan="1"> Chronic heart failure</td><td align="center" rowspan="1">4 (20)</td></tr><tr valign="top"><td align="left" rowspan="1"> Dyspnea</td><td align="center" rowspan="1">2 (10)</td></tr><tr valign="top"><td align="left" rowspan="1"> Venous insufficiency</td><td align="center" rowspan="1">1 (5)</td></tr><tr valign="top"><td align="left" rowspan="1"> Renal insufficiency</td><td align="center" rowspan="1">4 (20)</td></tr><tr valign="top"><td align="left" rowspan="1"> Arthritis</td><td align="center" rowspan="1">6 (30)</td></tr><tr valign="top"><td align="left" colspan="2" rowspan="1">Concomitant medications<sup>§</sup></td></tr><tr valign="top"><td align="left" rowspan="1"> Anti-hypertensive medication, excluding diuretics</td><td align="center" rowspan="1">18 (90)</td></tr><tr valign="top"><td align="left" rowspan="1"> Diuretics</td><td align="center" rowspan="1">14 (70)</td></tr><tr valign="top"><td align="left" rowspan="1"> Lipid-altering medication</td><td align="center" rowspan="1">9 (45)</td></tr><tr valign="top"><td align="left" rowspan="1"> Non-steroidal anti-inflammatory agents</td><td align="center" rowspan="1">2 (10)</td></tr><tr valign="top"><td align="left" rowspan="1"> Thiazolidinediones</td><td align="center" rowspan="1">1 (5)</td></tr><tr valign="top"><td align="left" rowspan="1"> Insulin</td><td align="center" rowspan="1">7 (35)</td></tr></tbody></table><table-wrap-foot><p>* Initial classification of edema was determined by a physician and based upon the classic clinical assessment of edema. Efforts were made to recruit patients with a range of edema severity and patients with no edema.</p><p><sup>†</sup> One patient was classified as having a medical history of edema consistent with lipedema but no edema was present at the time of the study.</p><p><sup>‡</sup> Lipedema is a entity distinguished clinically from lymphedema by the presence of soft symmetrical tissue enlargement of the lower extremities with sparing of the foot, ankle and upper extremities.[1]</p><p><sup>§</sup> Medications taken on the day of the visit.</p></table-wrap-foot></table-wrap><table-wrap position="float" id="t2"><label>Table 2.</label><caption><p>Inter-examiner agreement by interclass correlation coefficient (ICC).</p></caption><table frame="hsides" rules="groups"><thead><tr><td align="center" rowspan="1"></td><td align="center" colspan="2" rowspan="1"><bold>ICC* (95% confidence interval)</bold></td><td align="center" rowspan="1"></td><td align="center" rowspan="1"></td></tr><tr><td align="center" rowspan="1"><bold>Edema assessment tool</bold></td><td align="center" rowspan="1"><bold>Right</bold></td><td align="center" rowspan="1"><bold>Left</bold></td><td align="center" rowspan="1"><bold>Median recovery time (maximum)</bold></td><td align="center" rowspan="1"><bold>Average absolute difference (range)</bold></td></tr></thead><tbody align="left"><tr valign="top"><td align="left" rowspan="1">Water displacement (n=20)</td><td align="center" rowspan="1">0.93 (0.88, 0.97)</td><td align="center" rowspan="1">0.96 (0.93, 0.98)</td><td align="center" rowspan="1">-</td><td align="center" rowspan="1">5.1–71.9 mL<sup>†</sup></td></tr><tr valign="top"><td align="left" rowspan="1">Ankle circumference (n=20)</td><td align="center" rowspan="1">0.97 (0.94, 0.98)</td><td align="center" rowspan="1">0.97 (0.95, 0.99)</td><td align="center" rowspan="1">-</td><td align="center" rowspan="1">0.06–0.2 cm</td></tr><tr valign="top"><td align="left" rowspan="1">Figure of eight (n=12)</td><td align="center" rowspan="1">0.64 (0.41, 0.85)</td><td align="center" rowspan="1">0.86 (0.75, 0.95)</td><td align="center" rowspan="1">-</td><td align="center" rowspan="1">0.08–0.63 cm</td></tr><tr valign="top"><td align="left" colspan="5" rowspan="1">Clinical assessment – recovery (n=20)</td></tr><tr valign="top"><td align="left" rowspan="1"> Lower calf</td><td align="center" rowspan="1">0.53 (0.34, 0.73)</td><td align="center" rowspan="1">0.03 (−0.12, 0.29)</td><td align="center" rowspan="1">1 sec (3 min)</td><td align="center" rowspan="1">1–21.6 sec</td></tr><tr valign="top"><td align="left" rowspan="1"> Behind medial malleolus</td><td align="center" rowspan="1">0.28 (0.07, 0.54)</td><td align="center" rowspan="1">−0.01 (−0.16, 0.25)</td><td align="center" rowspan="1">1 sec (4.5 min)</td><td align="center" rowspan="1">2.7–26.1 sec</td></tr><tr valign="top"><td align="left" rowspan="1"> Dorsum of foot</td><td align="center" rowspan="1">0.05 (−0.13, 0.33)</td><td align="center" rowspan="1">0.11 (−0.08, 0.39)</td><td align="center" rowspan="1">1 sec (61 sec)</td><td align="center" rowspan="1">0.3–2.2 sec</td></tr><tr valign="top"><td align="left" rowspan="1"> Indirect leg volume (n=12)</td><td align="center" rowspan="1">0.53 (0.28, 0.80)</td><td align="center" rowspan="1">0.66 (0.44, 0.86)</td><td align="center" rowspan="1">-</td><td align="center" rowspan="1">9.4–238.8 mL</td></tr><tr valign="top"><td align="left" colspan="5" rowspan="1">Original edema tester – recovery</td></tr><tr valign="top"><td align="left" rowspan="1"> 100 mmHg (n=9)</td><td align="center" rowspan="1">0.48 (0.18, 0.81)</td><td align="center" rowspan="1">0.12 (−0.17, 0.60)</td><td align="center" rowspan="1">15.5 sec (4.3 min)</td><td align="center" rowspan="1">0.25–34.2 sec</td></tr><tr valign="top"><td align="left" rowspan="1"> 150 mmHg (n=9)</td><td align="center" rowspan="1">0.75 (0.55, 0.92)</td><td align="center" rowspan="1">0.43 (0.15, 0.78)</td><td align="center" rowspan="1">57 sec (8.6 min)</td><td align="center" rowspan="1">9.5–83.2 sec</td></tr><tr valign="top"><td align="left" colspan="5" rowspan="1">Modified edema tester – recovery</td></tr><tr valign="top"><td align="left" rowspan="1"> 4 mm, 100 mmHg (n=9)</td><td align="center" rowspan="1">0.65 (0.40, 0.88)</td><td align="center" rowspan="1">0.24 (−0.06, 0.68)</td><td align="center" rowspan="1">1.2 min (10 min)</td><td align="center" rowspan="1">16 sec–1 min 5 sec</td></tr><tr valign="top"><td align="left" rowspan="1"> 4 mm, 150 mmHg (n=9)</td><td align="center" rowspan="1">0.37 (0.14, 0.72)</td><td align="center" rowspan="1">0.68 (0.44, 0.89)</td><td align="center" rowspan="1">1.6 min (20 min)</td><td align="center" rowspan="1">23 sec–3 min 43 sec</td></tr><tr valign="top"><td align="left" rowspan="1"> 6 mm, 100 mmHg (n=9)</td><td align="center" rowspan="1">0.38 (0.15, 0.74)</td><td align="center" rowspan="1">0.72 (0.48, 0.91)</td><td align="center" rowspan="1">1.8 min (18 min)</td><td align="center" rowspan="1">27 sec–2 min 30 sec</td></tr><tr valign="top"><td align="left" rowspan="1"> 6 mm, 150 mmHg (n=20)</td><td align="center" rowspan="1">0.40 (0.21, 0.63)</td><td align="center" rowspan="1">0.75 (0.62, 0.87)</td><td align="center" rowspan="1">3.8 min (31 min)</td><td align="center" rowspan="1">1 min 37 sec–5 min 28 sec</td></tr></tbody></table><table-wrap-foot><p>* Interclass correlation coefficients of at least 0.75 are considered favorable.</p><p><sup>†</sup> Left 14.7 to 71.9 mL; Right 5.1 to 52.9 mL.</p></table-wrap-foot></table-wrap><table-wrap position="float" id="t3"><label>Table 3.</label><caption><p>Patient reported edema by questionnaire.</p></caption><table frame="hsides" rules="groups"><thead><tr><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="center" rowspan="1"></td><td align="center" colspan="3" rowspan="1"><bold>Examiner (%)</bold></td></tr><tr><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="center" rowspan="1"><bold>Average response (%)</bold></td><td align="center" rowspan="1"><bold>1</bold></td><td align="center" rowspan="1"><bold>2</bold></td><td align="center" rowspan="1"><bold>3*</bold></td></tr></thead><tbody align="left"><tr valign="top"><td align="left" rowspan="1">1.</td><td align="left" rowspan="1">Over the last week, how often did you have swelling in your ankles?</td><td align="left" rowspan="1">Every day</td><td align="center" rowspan="1">44.0</td><td align="center" rowspan="1">9 (45)</td><td align="center" rowspan="1">9 (45)</td><td align="center" rowspan="1">8 (42.1)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">6 days</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">5 days</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">4 days</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">3 days</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">2 days</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">1 day</td><td align="center" rowspan="1">5.1</td><td align="center" rowspan="1">1 (5)</td><td align="center" rowspan="1">1 (5)</td><td align="center" rowspan="1">1 (5.3)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Not at all</td><td align="center" rowspan="1">50.9</td><td align="center" rowspan="1">10 (50)</td><td align="center" rowspan="1">10 (50)</td><td align="center" rowspan="1">10 (52.6)</td></tr><tr valign="top"><td align="left" rowspan="1">2.</td><td align="left" rowspan="1">What level of swelling did you experience?</td><td align="left" rowspan="1">Extreme swelling</td><td align="center" rowspan="1">14.1</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">2 (20)</td><td align="center" rowspan="1">2 (22.2)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Quite a bit of swelling</td><td align="center" rowspan="1">20.4</td><td align="center" rowspan="1">3 (30)</td><td align="center" rowspan="1">2 (20)</td><td align="center" rowspan="1">1 (11.1)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Moderate swelling</td><td align="center" rowspan="1">10.0</td><td align="center" rowspan="1">2 (20)</td><td align="center" rowspan="1">1 (10)</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Mild swelling</td><td align="center" rowspan="1">34.4</td><td align="center" rowspan="1">4 (40)</td><td align="center" rowspan="1">3 (30)</td><td align="center" rowspan="1">3 (33.3)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Very little swelling</td><td align="center" rowspan="1">21.1</td><td align="center" rowspan="1">1 (10)</td><td align="center" rowspan="1">2 (20)</td><td align="center" rowspan="1">3 (33.3)</td></tr><tr valign="top"><td align="left" rowspan="1">3.</td><td align="left" rowspan="1">How much were you bothered by swelling in your ankles?</td><td align="left" rowspan="1">Extremely</td><td align="center" rowspan="1">7.0</td><td align="center" rowspan="1">1 (10)</td><td align="center" rowspan="1">1 (11.1)</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Quite a bit</td><td align="center" rowspan="1">3.7</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">1 (11.1)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Moderately</td><td align="center" rowspan="1">13.7</td><td align="center" rowspan="1">3 (30)</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">1 (11.1)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">A little</td><td align="center" rowspan="1">32.2</td><td align="center" rowspan="1">3 (30)</td><td align="center" rowspan="1">3 (33.3)</td><td align="center" rowspan="1">3 (33.3)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Not at all</td><td align="center" rowspan="1">43.3</td><td align="center" rowspan="1">3 (30)</td><td align="center" rowspan="1">5 (55.6)</td><td align="center" rowspan="1">4 (44.4)</td></tr><tr valign="top"><td align="left" rowspan="1">4.</td><td align="left" rowspan="1">During what times of day did you have swelling in your ankles?</td><td align="left" rowspan="1">Morning only</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Afternoon only</td><td align="center" rowspan="1">14.1</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">2 (20)</td><td align="center" rowspan="1">2 (22.2)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Evening only</td><td align="center" rowspan="1">48.5</td><td align="center" rowspan="1">4 (40)</td><td align="center" rowspan="1">5 (50)</td><td align="center" rowspan="1">5 (55.6)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Morning & afternoon</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Morning & evening</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Afternoon & evening</td><td align="center" rowspan="1">6.7</td><td align="center" rowspan="1">2 (20)</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Morning, afternoon,</td><td align="center" rowspan="1">30.7</td><td align="center" rowspan="1">4 (40)</td><td align="center" rowspan="1">3 (30)</td><td align="center" rowspan="1">2 (22.2)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">& evening</td><td align="center" rowspan="1"></td><td align="center" rowspan="1"></td><td align="center" rowspan="1"></td><td align="center" rowspan="1"></td></tr><tr valign="top"><td align="left" rowspan="1">5.</td><td align="left" rowspan="1">Did swelling in your ankles limit your normal activity?</td><td align="left" rowspan="1">Extremely</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Quite a bit</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Moderately</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">A little</td><td align="center" rowspan="1">7.0</td><td align="center" rowspan="1">1 (10)</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">1 (11.1)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Not at all</td><td align="center" rowspan="1">93.0</td><td align="center" rowspan="1">9 (90)</td><td align="center" rowspan="1">10 (100)</td><td align="center" rowspan="1">8 (88.9)</td></tr><tr valign="top"><td align="left" rowspan="1">6.</td><td align="left" rowspan="1">Did you have any difficulty answering these questions?</td><td align="left" rowspan="1">No</td><td align="center" rowspan="1">90</td><td align="center" rowspan="1">7 (70)</td><td align="center" rowspan="1">10 (100)</td><td align="center" rowspan="1">9 (100)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="left" rowspan="1"></td><td align="left" rowspan="1">Yes</td><td align="center" rowspan="1">10</td><td align="center" rowspan="1">3 (30)</td><td align="center" rowspan="1">--</td><td align="center" rowspan="1">--</td></tr></tbody></table><table-wrap-foot><p>* Only 19 patients evaluated.</p><p>© Merck & Co., Inc. Whitehouse Station, NJ, USA</p></table-wrap-foot></table-wrap><table-wrap position="float" id="t4"><label>Table 4.</label><caption><p>Mean Pearson correlation coefficients between assessments of lower extremity edema.</p></caption><table frame="hsides" rules="groups"><thead><tr><td align="left" rowspan="1"></td><td align="center" rowspan="1"><bold>Recovery time*</bold></td><td align="center" rowspan="1"><bold>Physician classification</bold><sup><bold>†</bold></sup></td></tr></thead><tbody align="left"><tr valign="top"><td align="left" rowspan="1">Pit depth, lower calf</td><td align="center" rowspan="1">0.53 (right)</td><td align="center" rowspan="1">0.59 (r)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="center" rowspan="1">0.67 (left)</td><td align="center" rowspan="1">0.54 (l)</td></tr><tr valign="top"><td align="left" rowspan="1">Pit depth, medial malleolus</td><td align="center" rowspan="1">0.42 (r)</td><td align="center" rowspan="1">0.53 (r)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="center" rowspan="1">0.66 (l)</td><td align="center" rowspan="1">0.46 (l)</td></tr><tr valign="top"><td align="left" rowspan="1">Pit depth, dorsum of foot</td><td align="center" rowspan="1">0.71 (r)</td><td align="center" rowspan="1">0.36 (r)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="center" rowspan="1">0.51 (l)</td><td align="center" rowspan="1">0.51 (l)</td></tr><tr valign="top"><td align="left" rowspan="1">Recovery time, lower calf</td><td align="center" rowspan="1"></td><td align="center" rowspan="1">0.31 (r)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="center" rowspan="1"></td><td align="center" rowspan="1">0.50 (l)</td></tr><tr valign="top"><td align="left" rowspan="1">Recovery time, medial malleolus</td><td align="center" rowspan="1"></td><td align="center" rowspan="1">0.23 (r)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="center" rowspan="1"></td><td align="center" rowspan="1">0.35 (l)</td></tr><tr valign="top"><td align="left" rowspan="1">Recovery time, dorsum of foot</td><td align="center" rowspan="1"></td><td align="center" rowspan="1">0.23 (r)</td></tr><tr valign="top"><td align="left" rowspan="1"></td><td align="center" rowspan="1"></td><td align="center" rowspan="1">0.33 (l)</td></tr><tr valign="top"><td align="left" rowspan="1">Patient-reported level of swelling<sup>‡</sup></td><td align="center" rowspan="1"></td><td align="center" rowspan="1">0.72</td></tr><tr valign="top"><td align="left" rowspan="1">Patient-reported frequency of swelling<sup>‡</sup></td><td align="center" rowspan="1"></td><td align="center" rowspan="1">0.61</td></tr></tbody></table><table-wrap-foot><p>* Pit depth and recovery time from clinical assessment.</p><p><sup><bold>†</bold></sup> Physician classification of edema (none, mild, moderate, severe) by standard clinical assessment.</p><p><sup>‡</sup> By questionnaire</p></table-wrap-foot></table-wrap><fig position="float" id="f1"><label>Figure 1.</label><caption><p>Edema tester.</p></caption><graphic xlink:href="21fig1g"></graphic></fig><fig position="float" id="f2"><label>Figure 2.</label><caption><p>Modified edema tester.</p></caption><graphic xlink:href="21fig2g"></graphic></fig><fig position="float" id="f3"><label>Figure 3.</label><caption><p>Baseline volumeter measuring device, foot set, 5x13x6 inches (reproduced with permission from WisdomKing.com).</p></caption><graphic xlink:href="21fig3c"></graphic></fig></floats-wrap></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001747 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 001747 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= LymphedemaV1
|flux= Pmc
|étape= Corpus
|type= RBID
|clé=
|texte=
}}
| This area was generated with Dilib version V0.6.31. |  |