Ask an answerable question (PICO)：
Maintaining the function and patency of the renal dialysis pathway is very important for patients with long-term hemodialysis. Arteriovenous fistulas (AVF) are still the preferred vascular access for long-term hemodialysis patients for it provides the longest lifetime and the lowest rate of complications. Stenosis and thrombosis formation are the main causes of AVF obstruction. Therefore, routine monitoring is essential to maintain the patency of AVF. Physical examination is the most basic and necessary technique in the guidelines. Observe that the currently used physical assessment forms are too brief to be accurately assessed and that the assessment results are inconsistent. Therefore, a new evaluation form is designed, evaluation items are listed, the accuracy of assessment is expected to be improved. We expect that we can use this assessment form to early diagnosis of AVF stenosis and do the early treatment to reduce the occurrence of AVF occlusion.
The Method and Analysis of Literature Review：
This study uses Evidence-based methods to set PICO keywords and uses Boolean logic AND and OR to search for databases such as Uptodate, Cochrane, PubMed, Embase, and CEPS, and selects the articles with higher levels to do the critical appraisal. We use CEBM's "Diagnostic Study Critical Appraisal Sheet Chinese Version" to conduct two cross-sectional research articles. The three main orientations of the review are V( Validity) /I(Impactity )/P (Practice).
Critical Appraisal：
According to the type of PICO problem, the appropriate literature was selected. Therefore, the second PICO was a diagnostic problem. Therefore, the most recent and highest grade cross-sectional study was selected for rigorous evaluation. According to Oxford CEBM 2011 Levels Of Evidence graded the articles, and the evaluation articles belonged to Level 2. The two literature reviewed were consistent with the physical assessment methods used for autologous arteriovenous fistulas.
Results, Conclusions and Recommendations：
AVF's physical assessment is an important assessment tool. It is a professional technique required by a kidney douche care professional. It requires no special instruments, can be performed with both hands, and can accurately diagnose autologous arteriovenous fistula stenosis. Therefore, it is recommended to use the new physical assessment scale to evaluate the fistula function of AVF dialysis patients at least once a week. Carefully perform an AVF assessment according to the items listed in the form to early diagnose AVF abnormalities and perform early treatment, and reduce the AVF occlusion rate.
