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Invited Critique
February 1, 2006

Clinical Indicators and Psychosocial Aspects in Peripheral Arterial Disease—Invited Critique

Arch Surg. 2005;140(2):166. doi:10.1001/archsurg.141.2.166

The increasing prevalence of PAD of the lower extremities, the wide range of therapies available to treat PAD, and the renewed emphasis on evidence-based outcomes to justify and guide treatment practices make it imperative that the therapeutic strategies used should improve functional status and QOL and preserve limb viability.1,2 The authors of an article in the current issue of the ARCHIVES assessed the contribution of psychosocial factors to the QOL of patients with PAD using several well-established assessment instruments. They found that in addition to the well-recognized objective clinical indicators, walking distance, physical function, and overall QOL were adversely affected by perceived stress. Quantifying the impact of PAD on health status from the patient's perspective is especially pertinent to individuals with intermittent claudication because therapy in most cases is directed primarily toward improving health status rather than preserving life or limb.3