Automated plethysmographic measurement of the ankle-brachial index: a comparison with the doppler ultrasound method

Abstract

The ankle-brachial index is widely regarded as a pivotal tool for the diagnosis and quantification of peripheral arterial disease. It is, however, plagued by issues relating to its time consuming nature and the skills required to undertake its measurement using the gold standard Doppler ultrasound method. Automated ankle-brachial index measurement devices aim to address such issues; this study aimed to compare the performance of such a device with the Doppler method. Three hundred and eighty participants, with risk factors for cardiovascular disease (mean age: 64, 57% male), underwent ankle-brachial index measurement firstly with a plethysmographic device followed by the Doppler method. The mean difference between the two methods was 0.016±0.1, 95% limits of agreement:±0.2. Sensitivity for detection of peripheral arterial disease, as defined by Doppler ankle-brachial index⩽0.9, was 70%, specificity 96%, accuracy 94%. A receiver operating curve revealed an area under the curve of.96, with a 1.04 plethysmographic ankle-brachial index cutoff for optimal sensitivity (98%) and specificity (75%). Automated measurements were significantly faster than Doppler measurements (7 min 55 s vs. 17 min 45 s, respectively, P <0.01). Although is it unclear if the plethysmographic device has sufficient diagnostic accuracy to be used as a stand alone test for the diagnosis of peripheral arterial disease, it is concluded that it can be used as a fast and amenable method of identifying people who require further arterial assessment; the higher cutoff point of 1.04 should be used for this purpose.

Atrial fibrillation influences automatic oscillometric ankle-brachial index measurement

“…However, the Bland-Altman analysis also showed low agreement of both methods ( Figure 5), both during atrial fibrillation and in sinus rhythm, when the Doppler method was considered as the reference. In addition to bias higher than reported by other authors [15], we observed wide limits of agreement, and almost 5% differences passing the 95% limit of agreement.…”

Non-invasive assessment of peripheral arterial disease: Automated ankle brachial index measurement and pulse volume analysis compared to duplex scan

“…However, a recent study compared ABIs attained with the same automated ABI device (Dopplex ABIlity) to ABIs undertaken with a hand-held Doppler. 17 The study population was of similar mean age (64 years) but did not contain any diabetics; it also returned a moderate sensitivity of 70% and good specificity of 96%.…”

“…Studies comparing Doppler ABI with UDS as the reference standard in diabetic populations also reported reduced sensitivities of 71%. 16 , 17 …”

Comparação do índice tornozelo-braquial com parâmetros de rigidez e resistência arterial periférica avaliados por fotopletismografia em idosos

“…In addition to these details, participants were asked whether or not they engaged in physical activity (PA) for at least 150 minutes per week. [17][18][19] No symptoms of PAD were assessed.…”