RT Journal Article SR Electronic T1 Primary care screening for peripheral arterial disease: a cross-sectional observational study JF British Journal of General Practice JO Br J Gen Pract FD British Journal of General Practice SP e103 OP e110 DO 10.3399/bjgp17X689137 VO 67 IS 655 A1 Jane H Davies A1 Jonathan Richards A1 Kevin Conway A1 Joyce E Kenkre A1 Jane EA Lewis A1 E Mark Williams YR 2017 UL http://bjgp.org/content/67/655/e103.abstract AB Background Early identification of peripheral arterial disease (PAD) and subsequent instigation of risk modification strategies could minimise disease progression and reduce overall risk of cardiovascular (CV) mortality. However, the feasibility and value of primary care PAD screening is uncertain.Aim This study (the PIPETTE study — Peripheral arterial disease In Primary carE: Targeted screening and subsequenT managEment) aimed to determine the value of a proposed primary care PAD screening strategy. Outcomes assessed were: prevalence of PAD and agreement of ankle– brachial index (ABI)-defined PAD (ABI ≤0.9) with QRISK®2-defined high CV risk (≥20).Design and setting A cross-sectional observational study was undertaken in a large general practice in Merthyr Tydfil, Wales.Method In total, 1101 individuals with ≥2 pre-identified CV risk factors but no known CV disease or diabetes were invited to participate. Participants underwent ABI measurement and QRISK2 assessment, and completed Edinburgh Claudication Questionnaires.Results A total of 368 people participated in the study (participation rate: 33%). Prevalence of PAD was 3% (n = 12). The number needed to screen (NNS) to detect one new case of PAD was 31. Refining the study population to those aged ≥50 years with a smoking history reduced the NNS to 14, while still identifying 100% of PAD cases. Of participants with PAD, 33% reported severe lifestyle-limiting symptoms of intermittent claudication that warranted subsequent endovascular intervention, yet had not previously presented to their GP. The QRISK2 score predicted high CV risk in 92% of participants with PAD.Conclusion The low PAD yield and the fact that QRISK2 was largely comparable to the ABI in predicting high CV risk suggests that routine PAD screening may be unwarranted. Instead, strategies to improve public awareness of PAD are needed.