Screening for Arteriopathy in General Medicine: a Preliminary Feasibility Study

Study Overview
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Brief Summary
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The main objective of this study is to evaluate the inter-observer concordance when measuring the maximum value of the external antero-posterior diameter of the sub-renal aorta (both cross-sectional and longitudinal ultrasound views are measured). The first measure is made by a general practitioner in private practice; second reading are made by an expert in vascular medicine.

Detailed Description
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The secondary objectives of this study are: A. To assess the prevalence of Abdominal Aortic Aneurysm (AAA) detected by ultrasound measurement of the anterior and posterior longitudinal outer diameter of the sub-renal abdominal aorta in a high cardiovascular risk population consulting with general practitioners (defined according to recommendations stated by the French Society of Vascular Medicine). B. To assess the prevalence of Peripheral Obliterative Arteriopathy of the Legs (POAL) by measuring the Systolic Pressure Index (SPI) at the toe (ratio of arterial pressure in upper limbs versus lower limbs). Measures are made by a general practitioner in the same population. C. To assess the quality and interpretability of ultrasound recordings and ultrasound acquistion failure rate. These second measures are made by an expert in vascular medecine. This evaluation with use a 3-level scale: appropriate image was not obtained or not recognized expert - uninterpretable poor image quality - interpretable image of good or very good quality - interpretable D. To calculate the impact of risk cofactors such as hypertension , smoking, age and family history among patients diagnosed with AAA. E. Evaluation of general practitioner training from a qualitative and quantitative point of view after 4 h of training organized by Dr. Bobbià .

Official Title
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Screening for Arteriopathy in General Medicine: a Preliminary Feasibility Study

Conditions
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Peripheral Obliterative Arteriopathy

Intervention / Treatment
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* Other: First ultrasound reading
* Other: Second ultrasound interpretation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The patient must have given his/her informed and signed consent The patient must be insured or beneficiary of a health insurance plan The patient falls into one of the following 4 groups as defined by the French Society of Vascular Medecin (2006): (1) Men and women 60-75 years of age who are active smokers or ex-smokers (2) Men over 75 years of age (3) Women over 75 years of age who smoke and who have known hypertension (4) Men and women over 50 years of age with a family history of aneurysm of the abdominal aorta Exclusion Criteria: The patient is in an exclusion period determined by a previous study The patient is under judicial protection, under tutorship or curatorship The patient refuses to sign the consent It is impossible to correctly inform the patient The subject has an allergy to the gel used for ultrasound examination.

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| The study population<br>See inclusion/exclusion criteria. Intervention: First ultrasound reading Intervention: Second ultrasound interpretation | Other: First ultrasound reading<br>* First ultrasound reading of the sub-renal abdominal aorta by a general practitioner.<br>Other: Second ultrasound interpretation<br>* The untrasound images recorded by general practitioners will be interpreted a second time by an expert in vascular medecine, and evaluated for their image quality.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Largest external antero-posterior diameter of the sub-renal abdominal aorta (mm) | Measures made using both cross-sectional and longitudinal ultrasounds. | Baseline (day 0) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| SPI at the toe (mmHg) |  | baseline (Day 0) | 
| Largest external antero-posterior diameter of the sub-renal abdominal aorta (mm) : second interpretation of echographic material by a second expert | Measures made using both cross-sectional and longitudinal ultrasounds. | maximum of three months | 
| Ultrasound quality as assessed by the second expert | This evaluation with use a 3-level scale: appropriate image was not obtained or not recognized expert - uninterpretable poor image quality - interpretable image of good or very good quality - interpretable | maximum of three months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Peripheral Obliterative Arteriopathy of the legs, Screening by generalists, Ultrasound