Validity and reliability of the ankle-brachial index by oscillometric blood pressure and automated ankle-brachial index

Abstract

Background:This study was conducted to assess the validity and reliability of ankle-brachial index (ABI) by oscillometric blood pressure (BP) measurement as compared with an automated ABI as a gold standard.Materials and Methods:This study was conducted at Golden Jubilee Medical Center, Thailand. All the data were collected from 303 patients at risk of peripheral arterial disease (PAD) who were 45 years of age or above and who underwent treatment at the outpatient medical clinic between June and December 2015. Patients who were followed up at the medical clinic had both oscillometric BP measurement (Terumo, ES-P600) and an automated ABI (oscillometric method) at the same time. Sensitivity, specificity, positive predictive value, and negative predictive value of the oscillometric BP measurements to predict an abnormal ABI (<0.90) were determined using the automated ABI as the gold standard.Results:ABI values were similar between the two methods. The oscillometric BP method for determining an ABI (cutoff point <0.90) on the right side had a sensitivity of 88.89%, specificity of 99.32%, an accuracy of 99.01%, a positive predictive value of 80%, and a negative predictive value of 99.32% whereas ABI on the left side had a sensitivity of 69.23%, a specificity of 99.66%, an accuracy of 98.35%, a positive predictive value of 90%, and a negative predictive value of 98.63%. Reliability of the oscillometric BP method by Kappa statistics was 0.84 on the right side and 0.77 on the left side (P = 0.000).Conclusion:The oscillometric BP method is a reliable and useful alternative to conventional automated ABI determination in patients with no severe arterial occlusion for estimation of the prevalence and screening of PAD in primary health-care settings.

Screening, Sensitivity, Specificity, and So Forth: A Second, Somewhat Skeptical, Sequel

“…A fourth issue relates to unsound investigative logic sometimes being employed. For example, Chongthawonsatid and Dutsadeevettakul (2017) assessed sensitivity, specificity, predictive values, and accuracy (Note 5) of the ABI by comparing results from one method of obtaining ABIs with another, the second of which they referred to as a "gold standard". In this situation, two highly similar screening tests were compared with each other and no diagnostic-level measure of PAD was involved.…”

The reliability of the ankle brachial index: a systematic review

“…Twenty-one papers were excluded based on the exclusion criteria (Fig. 1): 10 papers reported comparison of methods [26][27][28][29][30][31][32][33][34][35], five studies did not report measures of reliability [36][37][38][39][40], two studies compared raters' experience [41,42] and one reported a novel trial design, for which the reliability results were duplicated in another included paper [43]. One paper used measures repeated at up to 365 days apart, with a mean time between measures of 228 days, which is long enough to encompass changes attributable to progression of PAD [44].…”

“Off-label” Usage of an Oxidized Zirconium Femoral Head in Revision of a Total Hip Arthroplasty with Mechanically Assisted Crevice Corrosion and a Legacy Taper

“…3). Vascular compromise was further supported by ultrasound showing an ankle-brachial index [11] of 0.50 on the affected side compared with 1.66 on the right. Joint aspiration was negative for evidence of bacterial infection (no growth at 14 days; cell count not available because of cell debris), but serum Co and Cr levels were abnormally elevated.…”