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An evaluation of symptom classification systems used for the assessment of patients with heart failure in France
Author(s) -
Gibelin P.
Publication year - 2001
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/s1388-9842(01)00206-9
Subject(s) - exertion , medicine , test (biology) , heart failure , scale (ratio) , variety (cybernetics) , physical therapy , artificial intelligence , computer science , paleontology , physics , quantum mechanics , biology
Many systems have been proposed to assess the degree of functional impairment in patients with chronic heart failure in order to be able to draw comparisons between patients and assess the development of the disease in the same patient. The NYHA classification is subjective and insufficiently reproducible and has no real predictive value with respect to the exertion test. The Canadian classification does not contribute much in terms of validation. The Feinstein and Duke University classifications are too complex, not very easy to use and have never been validated. The scale of activity proposed by Goldman gives details on functional impairment by using examples from daily activities, selected for their variety and grouped according to the energy that they require. This classification is highly reproducible and is concordant with the exertion test (duration of the exertion test, V O 2 max). However, it is not suitable for France. The examples are not precise enough: in addition, they do not eliminate contradictions that can make the patient impossible to classify. We propose a scale of activity specifically designed for use in France. It is reproducible and the V O 2 peaks are highly concordant. Lastly, the questions the patient is asked are progressive, thus avoiding contradictory answers. This classification could prove to be useful in everyday life and also for multi‐center studies in French‐speaking countries.