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The Edinburgh Claudication Questionnaire has poor diagnostic accuracy in people with intermittent claudication

Ibeggazene, Saïd; Cai, Paris L.; Smith, George E.; Ibbegazene, Said; Stirrup, Andrew; Pymer, Sean; Palmer, Joanne; Cai, Paris; Smith, George; Chetter, Ian C.


Saïd Ibeggazene

Paris L. Cai

George E. Smith

Said Ibbegazene

Andrew Stirrup

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Mr Sean Pymer
Academic Clinical Exercise Physiologist

Joanne Palmer

Paris Cai


Background: The screening and diagnosis of intermittent claudication is a challenging process and often relies on the expertise of specialist vascular clinicians. We sought to investigate the diagnostic performance of the Edinburgh Claudication Questionnaire (ECQ) as a screening tool for referrals of suspected intermittent claudication from primary to secondary care. Method: Prospectively, 100 referrals from primary care with a stated diagnosis or query regarding intermittent claudication were recruited. All participants who completed the ECQ, underwent an anklebrachial pressure index (ABPI) assessment and treadmill exercise testing. Outcomes of the ECQ were compared to clinical diagnoses of intermittent claudication. Results: The ECQ had a sensitivity of 46.8% (95% CI: 27–65%), specificity of 63.2% (95% CI: 43–82%) and accuracy of 53.0% (95% CI: 43–63%). The diagnostic performance was not changed by combining the ECQ with a positive ABPI or post-exercise ABPI outcome for PAD. Conclusion: The ECQ had a poor diagnostic performance in this cohort. Considering the results found here and in other recent studies, the utility of the ECQ as a screening tool and epidemiological survey tool must be questioned. Novel, low-resource diagnostic tools are needed in this population.


Ibeggazene, S., Cai, P. L., Smith, G. E., Ibbegazene, S., Stirrup, A., Pymer, S., …Chetter, I. C. (in press). The Edinburgh Claudication Questionnaire has poor diagnostic accuracy in people with intermittent claudication. Vascular,

Journal Article Type Article
Acceptance Date Oct 25, 2021
Online Publication Date Feb 10, 2022
Deposit Date Dec 7, 2021
Publicly Available Date Jan 4, 2022
Journal Vascular
Print ISSN 1708-5381
Electronic ISSN 1708-539X
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Keywords Intermittent claudication; Diagnosis; Peripheral artery disease
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© The Author(s) 2022. article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (

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©2021 The authors. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder

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Author(s), Contribution Title, Journal Title (Journal Volume Number and Issue Number) pp. xx-xx. Copyright © [year] (Copyright Holder). DOI: [DOI number].

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