Non-invasive assessment of peripheral arterial disease: Automated ankle brachial index measurement and pulse volume analysis compared to duplex scan
Lewis, Jane E. A.
Davies, Jane H.
MetadataDangos cofnod eitem llawn
Objectives: This cross-sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (1) ankle brachial index and (2) pulse volume waveform analysis recorded by the same automated device, with the presence or absence of peripheral arterial disease being verified by ultrasound duplex scan. Methods: Patients (n=205) referred for lower limb arterial assessment underwent ankle brachial index measurement and pulse volume waveform recording using volume plethysmography, followed by ultrasound duplex scan. The presence of peripheral arterial disease was recorded if ankle brachial index <0.9; pulse volume waveform was graded as 2, 3 or 4; or if haemodynamically significant stenosis >50% was evident with ultrasound duplex scan. Outcome measure was agreement between the measured ankle brachial index and interpretation of pulse volume waveform for peripheral arterial disease diagnosis, using ultrasound duplex scan as the reference standard. Results: Sensitivity of ankle brachial index was 79%, specificity 91% and overall accuracy 88%. Pulse volume waveform sensitivity was 97%, specificity 81% and overall accuracy 85%. The combined sensitivity of ankle brachial index and pulse volume waveform was 100%, specificity 76% and overall accuracy 85%. Conclusion: Combining these two diagnostic modalities within one device provided a highly accurate method of ruling out peripheral arterial disease, which could be utilised in primary care to safely reduce unnecessary secondary care referrals.
Sage Open Medicine;
Lewis, E.A., Williams, P. and Davies, J.H. (2016) 'Non-invasive assessment of peripheral arterial disease: Automated ankle brachial index measurement and pulse volume analysis compared to duplex scan', SAGE Open Medicine, 4, p.2050312116659088.
Dynodwr Gwrthrych Digidol (DOI)http://dx.doi.org/10.1177/2050312116659088
This article was published in Sage Open Medicine on 12 July 2016, available open access at http://dx.doi.org/10.1177/2050312116659088
HawliauCreative Commons Attribution License or Creative Commons Attribution Non-Commercial License available:https://creativecommons.org/licenses/by-nc/3.0/
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
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Davies, Jane H.; Lewis, Jane E.A.; Williams, E. Mark (European Wound Management Association, 2014)Background: The ankle brachial index is widely used for non-invasive assessment of lower limb arterial status, but has recognised limitations. The most significant limitation involves arterial calcification, which results ...
Davies, Jane H.; Lewis, Jane E. A.; Williams, E. Mark (EWMA, 2014-10-01)Background: The ankle brachial index is widely used for non-invasive assessment of lower limb arterial status, but has recognised limitations. The most significant limitation involves arterial calcification, which results ...
The Pulse Volume Recorder as a Measure of Peripheral Vascular Status in People with Diabetes Mellitus Lewis, Jane E. A.; Owens, David (Mary Ann Liebert, 2010-01-18)Background: Peripheral vascular disease is common in persons with diabetes. There is growing evidence that the vascular contribution to foot disease in diabetes is greater than has previously been realized. Methods: A ...