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

Davies, Jane H. and Williams, E. Mark 2015. Automated plethysmographic measurement of the ankle-brachial index: a comparison with the doppler ultrasound method. Hypertension Research 39 (2) , pp. 100-106. 10.1038/hr.2015.124

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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 indexless than or equal to0.9, 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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Biosciences Medicine
Publisher:	Nature Publishing Group
ISSN:	0916-9636
Funders:	KESS
Date of Acceptance:	24 September 2015
Last Modified:	18 Jun 2022 07:43
URI:	https://orca.cardiff.ac.uk/id/eprint/87523

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