Quality of Life Measures in Lower Limb Ischaemia

  • F. A. K. Mazari
  • T. A. Mehta
  • I. C. Chetter
Reference work entry


Lower limb ischaemia is a common condition which causes significant morbidity amongst sufferers. It represents a disease spectrum and may manifest as intermittent claudication (IC) or critical limb ischaemia (CLI). IC is characterized by muscular lower limb pain on exertion, and thus IC limits not only walking capacity and physical activity, but also impairs other quality of life (QOL) domains including social functioning, emotional and mental health. CLI is characterized by ischaemic rest pain ± tissue loss and, in contrast to IC, is a limb threatening condition. Patients with CLI demonstrate severe QOL impairment. Treatment in LLI therefore aims to preserve the limb and thus improve QOL. Many different generic and disease specific instruments have been utilized in the analysis of QOL in patients with LLI, and the following chapter examines these in detail. We would recommend that in terms of validity, reliability and responsiveness the SF36 is the most useful generic instrument and the VascuQOl is the most useful disease specific instrument for QOL analysis in patients with LLI.


Critical Limb Ischaemia Intermittent Claudication Nottingham Health Profile Sickness Impact Profile Intermittent Claudication 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:


ankle brachial index


ankle brachial pressure index


bodily pain


claudication scale


critical limb ischaemia




functional limitations profile


general health


health insurance experiment


health utilities index


intermittent claudication


international quality of life assessment project


lower limb ischaemia


mental component summary


mental health


medical outcomes study


nottingham health profile


physical component summary


Physical function


peripheral vascular disease


quality adjusted life years


quality of life


quality of well being


quality of well being-self administered


role emotional


role physical


social functioning


short form 12


short form 20


short form 36


short form 8


sickness impact profile


symptom specific questionnaire


time trade off


visual analogue scale




world health organization


walking impairment questionnaire


  1. Arfvidsson B, Karlsson J, Dahllof AG, Lundholm K, Sullivan M. (1993). Eur J Clin Invest. 23: 741–745.PubMedCrossRefGoogle Scholar
  2. Bergner M. (1993). Development Testing and Use of The Sickness Impact Profile. Kluwer, Boston, MA.Google Scholar
  3. Bergner M, Bobbitt RA, Carter WB, Gilson BS. (1981). Med Care. 19: 787–805.PubMedCrossRefGoogle Scholar
  4. Bergner M, Bobbitt RA, Kressel S, Pollard WE, Gilson BS, Morris JR. (1976). Int J of Health Serv. 6: 393–415.CrossRefGoogle Scholar
  5. Bergner M, Bobbitt RA, Pollard WE, Martin DP, Gilson BS. (1976). Med Care. 14: 57–67.PubMedCrossRefGoogle Scholar
  6. Bosch J, Hunink M. (2000). Qual of Life Res. 9: 591–601.CrossRefGoogle Scholar
  7. Bosch JL, van der Graaf Y, Hunink MG. (1999). Circulation. 99: 3155–3160.PubMedGoogle Scholar
  8. Bowling A. (1997). Measuring Health: A Review of Quality of Life Measurement Scales. Open University Press, Buckhingham.Google Scholar
  9. Bowling MH, Furlong W, Feeny D, Torrance GW, Hatcher J. (1995). Qual Life Res. 4: 249–257.CrossRefGoogle Scholar
  10. Brazier JE, Harper R, Jones N, O’Cathain A, Thomas KJ, Usherwood T, Westlake L. (1992). BMJ. 305: 160–164.PubMedCrossRefGoogle Scholar
  11. Brazier J, Jones N, Kind P. (1993). Qual Life Res. 2: 169–180.PubMedCrossRefGoogle Scholar
  12. Brazier J, Roberts J, Deverill M. (2002). J Health Econ. 21: 271–292.PubMedCrossRefGoogle Scholar
  13. Bullinger M, Cachovan M, Creutzig A, Diehm C, Gruss J, Heidrich H, Kirchberger I, Loeprecht H, Rogatti W. (1996). Vasa. 25(1): 32–40.PubMedGoogle Scholar
  14. Charlton JR, Patrick DL, Peach H. (1983). J Epidemiol Community Health. 37(4): 296–304.PubMedCrossRefGoogle Scholar
  15. Chetter IC, Spark JI, Dolan P, Scott DJ, Kester RC. (1997). Eur J Vasc Endovasc Surg. 13: 597–604.PubMedCrossRefGoogle Scholar
  16. Chong PF, Garratt AM, Golledge J, Greenhalgh RM, Davies AH. (2002). J Vasc Surg. 36: 764–771.PubMedGoogle Scholar
  17. Coons SJ, Rao S, Keininger DL, Hays RD. (2000). Pharmacoeconomics. 17: 13–35.PubMedCrossRefGoogle Scholar
  18. de Bruin AF, de Witte L, Stevens F, Diederiks JP. (1992). Soc Sci Med. 35(8): 1003–1014.PubMedCrossRefGoogle Scholar
  19. De Charro F, Rabin R. (1999). “EQ-5D from the EuroQol group: an update.” Quality of Life Newsletter (May-Aug): 3–4.Google Scholar
  20. Dorman P, Slattery J, Farrell B, Dennis M, Sandercock P. (1998). Stroke. 29(1): 63–68.PubMedGoogle Scholar
  21. Essink-Bot ML, Bonsel GJ, van der Maas PJ. (1990). Soc Sci Med. 31(11): 1201–1206.PubMedCrossRefGoogle Scholar
  22. Essink-Bot ML, Krabbe PF, Bonsel GJ, Aaronson NK. (1997). Med Care. 35(5): 522–537.PubMedCrossRefGoogle Scholar
  23. Feeny D, Furlong W, Barr RD, Torrance GW, Rosenbaum P, Weitzman S. (1992). J Clin Onco10(6): 923–928.Google Scholar
  24. Feeny D, Furlong W, Boyle M, Torrance GW. (1995). Pharmacoeconomics. 7(6): 490–502.PubMedCrossRefGoogle Scholar
  25. Fitzpatrick R, Ziebland S, Jenkinson C, Mowat A, Mowat A. (1992). Qual Health Care. 1(2): 89–93.PubMedCrossRefGoogle Scholar
  26. Fowkes FG, Housley E, Cawood EH, Macintyre CC, Ruckley CV, Prescott RJ. (1991). Int J Epidemiol. 20(2): 384–392.PubMedCrossRefGoogle Scholar
  27. Heidrich H, Bullinger M, Cachovan M, Creutzig A, Diehm C, Gruss JD, Kirchberger I, Loeprecht H, Rogatti W. (1995). Med Klin (Munich). 90(12): 693–697.Google Scholar
  28. Hunt SM, McEwen J, McKenna SP. (1985). J R Coll Gen Pract. 35(273): 185–188.PubMedGoogle Scholar
  29. Hunt SP, McEwan, et al. (1986). Measuring Health Status. Croom Helm, London.Google Scholar
  30. Hurst NP, Ruta DA, Kind P. (1998). Br J Rheumatol. 37(8): 862–869.PubMedCrossRefGoogle Scholar
  31. Johnson JA, Coons SJ. (1998). Qual Life Res. 7(2): 155–166.PubMedCrossRefGoogle Scholar
  32. Kaplan R, Anderson J (eds.) (1988). The Quality of Well Being Scale: Rationale for A Single Quality of Life Index. Quality of Life: Assessment and Applications. MTP, Lancaster.Google Scholar
  33. Khaira HS, Hanger R, Shearman CP. (1996). Eur J Vasc Endovasc Surg. 11(1): 65–69.PubMedCrossRefGoogle Scholar
  34. Kiely JM, Brasel KJ, Guse CE, Weigelt JA. (2006). J Surg Res. 15;132: (2)214–218.CrossRefGoogle Scholar
  35. Kind P. (1988). Development of Health Indices. Wiley, chichester.Google Scholar
  36. Kind P, Rosser R. (1988). Eur J Soc Psychol. 18: 63–77.CrossRefGoogle Scholar
  37. Klevsgård R, Fröberg BL, Risberg B, Hallberg IR. (2002). J Vasc Surg. 36(2): 310–317.PubMedCrossRefGoogle Scholar
  38. Marquis P, Comte S, Lehert P. (2001). Pharmacoeconomics. 19(6): 667–677.PubMedCrossRefGoogle Scholar
  39. Marquis P, Lecasble M, Passa P. (1998). Drugs. 56 Suppl. 3: 37–48.Google Scholar
  40. McDermott MM, Liu K, Guralnik JM, Martin GJ, Criqui MH, Greenland P. (1998). J Vasc Surg. 28(6):1072–1081.PubMedCrossRefGoogle Scholar
  41. McHorney CA, Ware JE Jr., Rogers W, Raczek AE, Lu JF. (1992). Med Care. 30(5 Suppl): MS253–265.PubMedCrossRefGoogle Scholar
  42. McKenna SP, Hunt SM, McEwen J. (1981). Int J Epidemiol. 10: 93–97.PubMedCrossRefGoogle Scholar
  43. Mehta T, Venkata Subramaniam A, Chetter I, McCollum P. (2006). Eur J Vasc Endovasc Surg. 31(1): 46–52.PubMedCrossRefGoogle Scholar
  44. Morgan MB, Crayford T, Murrin B, Fraser SC. (2001). J Vasc Surg. 33(4): 679–687.PubMedCrossRefGoogle Scholar
  45. Morris JN, Suissa S, Sherwood S, Wright SM, Greer D. (1986). J Chronic Dis. 39(1): 47–62.PubMedCrossRefGoogle Scholar
  46. Nelson EC, Landgraf JM, Hays RD, Wasson JH, Kirk JW. (1990). Med Care. 28(12): 1111–111126.PubMedCrossRefGoogle Scholar
  47. Nelson E, Wasson J, Kirk J, Keller A, Clark D, Dietrich A, Stewart A, Zubkoff M. (1987). J Chronic Dis. 40 Suppl. 1: 55S–69S.PubMedCrossRefGoogle Scholar
  48. Patrick DL, Deyo RA. (1989). Med Care. 27(3 Suppl):S217–232.PubMedCrossRefGoogle Scholar
  49. Patrick DL, Sittampalam Y, Somerville SM, Carter WB, Bergner M. (1985). Am J Public Health. 75(12):1402–1407.PubMedCrossRefGoogle Scholar
  50. Pell JP. (1995). Eur J Vasc Endovasc Surg. 9(4):469–472.PubMedCrossRefGoogle Scholar
  51. Rosser RM, Watts VC. (1972). Int J Epidemiol. 1(4):361–368.PubMedCrossRefGoogle Scholar
  52. Rubenach S, Shadbolt B, McCallum J, Nakamura T. (2002). J Clin Epidemiol. 55(3): 306–309.PubMedCrossRefGoogle Scholar
  53. Saigal S, Feeny D, Furlong W, Rosenbaum P, Burrows E, Torrance G. (1994). J Pediatr. 125(3): 418–425.PubMedCrossRefGoogle Scholar
  54. Spengel FA, Lehert P, Dietze S. (1998). Vasa. 27(4): 253.PubMedGoogle Scholar
  55. Spitzer WO, Dobson AJ, Hall J, Chesterman E, Levi J, Shepherd R, Battista RN, Catchlove BR. (1981). J Chronic Dis. 34(12): 585–597.PubMedCrossRefGoogle Scholar
  56. Stewart, A, Ware J. (1992). Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Duke University Press, Durhan, NC.Google Scholar
  57. Tandon PK, Stander H, Schwarz RP. Jr (1989). J Clin Epidemiol. 42(10): 955–962.PubMedCrossRefGoogle Scholar
  58. The EUROQOL Group. (1999). Health Policy. 16(3): 199–208.Google Scholar
  59. Torrance GW, Furlong W, Feeny D, Boyle M. (1995). Pharmacoeconomics. 7(6): 503–520.PubMedCrossRefGoogle Scholar
  60. van Agt HM, Essink-Bot ML, Krabbe PF, Bonsel GJ. (1994). Soc Sci Med. 39(11):1537–1544.PubMedCrossRefGoogle Scholar
  61. van Wijck EE, Bosch JL, Hunink MG. (1998). Med Decis Making. 18(4): 400–405.PubMedCrossRefGoogle Scholar
  62. Wann-Hansson C, Hallberg IR, Risberg B, Klevsgård R. (2004). Health Qual Life Outcomes. 17;2:9.CrossRefGoogle Scholar
  63. Ware JE Jr (1987). J Chronic Dis. 40(6): 473–480.PubMedCrossRefGoogle Scholar
  64. Ware J, Kosinski M. (1994). SF36 Physical and Mental Health Summary Scales: A Users Manual. The Health Institute, Boston, MA.Google Scholar
  65. Ware J, Kosinski M (eds.) (2000). How to Score Version Two of The SF36 Health Survey. Lincoln, MI, QualityMetric, Incorporated.Google Scholar
  66. Ware J Jr, Kosinski M, Keller SD. (1996). Med Care. 34(3): 220–233.PubMedCrossRefGoogle Scholar
  67. Ware JE Jr, Sherbourne CD. (1992). Med Care. 30(6): 473–483.PubMedCrossRefGoogle Scholar
  68. Ware J, Snow K. (1993). SF36 Health Survey Manual and Interpretation Guide. Boston, MA, New England Medical Centre, The Health Institute. World Health Organization: The constitution of WHO 1947 1: 29.Google Scholar
  69. WHOQOL Group. (1993). Quality of Life Research. 2: 153–159.Google Scholar
  70. Williams A. (1995). The measurement and Valuation of Health: A Chronicle. Discussion Paper 136, Centre for Health Economics. The University of York,York.Google Scholar

Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • F. A. K. Mazari
  • T. A. Mehta
  • I. C. Chetter

There are no affiliations available

Personalised recommendations