A comparison of the Doppler ultrasound interpretation by student and registered podiatrists

Abstract

BackgroundHand held Doppler ultrasound machines are routinely used by podiatrists to assess the arterial perfusion of the lower limb. They are practical, painless and effective as a screening tool, and the available general evidence would suggest that interpretation by practitioners is reliable. This study compared the abilities of student and Health and Care Professions Council (HCPC) registered podiatrists to identify correctly Doppler ultrasound outputs.MethodA prospective single blind comparative study design was utilised. Fifteen Doppler recordings of the blood flow in the posterior tibial artery, five each of monophasic, biphasic and triphasic blood flow, were used to compare the interpretation abilities of 30 undergraduate podiatry students and 30 HCPC registered podiatrists. Chi-squared analysis of the results was undertaken.ResultsChi-squared analysis found that there was no statistically significant difference between the overall abilities of student podiatrists and HCPC registered podiatrists to identify correctly Doppler ultrasound recordings (p = 0.285). No significant difference was found in their ability to identify Doppler ultrasound recordings of monophasic, biphasic or triphasic blood flow (p > 0.050).ConclusionThe results of this relatively small study suggest that both student and HCPC registered podiatrists are in general able to identify the nature of blood flow based on the output of handheld Doppler ultrasound units. However, the results raise an issue regarding professional development of practitioners who might have been expected to have enhanced their skills of Doppler ultrasound sound identification since professional registration.

Survey of ultrasound practice amongst podiatrists in the UK

“…Where the use of vascular hand-held Doppler by podiatrists has been reviewed, it has been found in one study that ability to interpret different waveform signals was reasonable, although practitioners expressed concern over their own competence, citing a lack of specific knowledge, training or experience [ 14 ]. Another study has shown poor reliability around interpretation, when looking at both visual and audible waveforms; the need for clinicians to engage in regular and ongoing education was highlighted [ 15 ].…”

Audible handheld Doppler ultrasound determines reliable and inexpensive exclusion of significant peripheral arterial disease

“…Additionally, there are some publications that are skeptical about distinguishing three types of audible Doppler signals, but would prefer to state if the signal is present or absent. On the contrary, Young et al 14 determined the reliability of AHDU waves comparing students with registered podiatrists and demonstrated the accuracy of audible output interpretation by podiatrists. The strength of our study includes the high interrater reliability test of 87.5% agreement between the physician and the nurse performing AHDU, the wide availability of portable handheld Doppler ultrasound device along with the ability to perform the test in a shorter time frame.…”

Use of hand‐held Doppler ultrasound examination by podiatrists: a reliability study

“…Previous studies have shown much higher levels of reliability in analysis of audio waveforms in podiatrists [ 14 , 15 ]. The differences in reliability between private and public sector podiatrists may be due in part, to the differences between the public and private participant (i.e., patient) groups.…”