TY - JOUR
T1 - Screening for dialysis access graft malfunction
T2 - comparison of physical examination with US
AU - Trerotola, Scott O.
AU - Scheel, Paul J.
AU - Powe, Neil R.
AU - Prescott, Carol
AU - Feeley, Nancy
AU - He, Jiang
AU - Watson, Alan
PY - 1996
Y1 - 1996
N2 - PURPOSE: To test the reliability and performance of two physical diagnosis algorithms for use in physical examination of vascular access grafts. MATERIALS AND METHODS: Grafts were assessed in 39 patients by means of physical examination performed by four observers. Grafts were characterized as having a thrill, pulse, or indeterminate examination at three locations (arterial, midpoint, venous). Findings with this algorithm were compared with those from ultrasound (US) with volume flow measurements. RESULTS: Patients with a thrill at all three locations of the graft all had volume flows greater than 450 mL/min (negative predictive value = 100%). Of patients with a pulse at any of the three locations, only 28% (positive predictive value) had a volume flow of 450 mL/ min or less. CONCLUSION: Physical examination is a good screening test for ruling out the low flows associated with impending access graft failure, thereby eliminating the need for routine US for many patients.
AB - PURPOSE: To test the reliability and performance of two physical diagnosis algorithms for use in physical examination of vascular access grafts. MATERIALS AND METHODS: Grafts were assessed in 39 patients by means of physical examination performed by four observers. Grafts were characterized as having a thrill, pulse, or indeterminate examination at three locations (arterial, midpoint, venous). Findings with this algorithm were compared with those from ultrasound (US) with volume flow measurements. RESULTS: Patients with a thrill at all three locations of the graft all had volume flows greater than 450 mL/min (negative predictive value = 100%). Of patients with a pulse at any of the three locations, only 28% (positive predictive value) had a volume flow of 450 mL/ min or less. CONCLUSION: Physical examination is a good screening test for ruling out the low flows associated with impending access graft failure, thereby eliminating the need for routine US for many patients.
KW - Dialysis, shunts
KW - Ultrasound (US), comparative studies
UR - http://www.scopus.com/inward/record.url?scp=0029690931&partnerID=8YFLogxK
U2 - 10.1016/S1051-0443(96)70726-1
DO - 10.1016/S1051-0443(96)70726-1
M3 - Article
C2 - 8773969
AN - SCOPUS:0029690931
SN - 1051-0443
VL - 7
SP - 15
EP - 20
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 1
ER -