Automated determination of the ankle-brachial index using an oscillometric blood pressure monitor: validation vs. Doppler measurement and cardiovascular risk factor profile

Κόλλιας, Αναστάσιος; Xilomenos, Apostolos; Protogerou, Athanase D.; Dimakakos, Evangelos; Stergiou, George S.

doi:10.1038/hr.2011.53

Cited by 58 publications

(66 citation statements)

References 25 publications

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“…These studies included 4186 subjects, most of whom had been referred to a vascular clinic, indicating that they had vascular disease and/or cardiovascular risk factors (patient characteristics in Table 2). Of the 20 devices used in these studies, 5 were designed for ABI measurements, [19][20][21][22][23]37,38,41 8 were validated for arm BP measurement 19,24-31 and 10 had not been validated 7,14,[20][21][22][23][32][33][34][35][36][37][38][39][40][41] ( Table 1). The heterogeneity (I 2 ) among the studies was 73%, and a Funnel plot indicates a minor publication bias (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…Positive and negative study conclusion In 18 of the 25 studies reviewed in this paper (72%; n ¼ 3449), 7,14,[19][20][21][22][23][25][26][27][28]31,[34][35][36]38,40 the authors arrived at a conclusion in favor of oscillometric ABI measurement. Studies with Table 1a Studies that compared the oscillometric with Doppler method for ankle-brachial index measurement a positive conclusion compared with those with a negative one reported a lower but not significant average Doppler-oscillometric ABI difference (0.012±0.010 vs. 0.047±0.035 P ¼ 0.38) and absolute ABI difference (0.044 ± 0.011 vs. 0.060 ± 0.021; P ¼ 0.51), and a significantly higher sensitivity for PAD diagnosis (80 ± 3% vs. 51±5%; Po0.001).…”

Section: Methods and Device Type Analysesmentioning

confidence: 93%

“…The most common method (10 studies) was to select the higher pressure (posterior tibial artery or dorsalis pedis artery) for each ankle divided by the higher brachial pressure of the two arms (left or right). 7,14,19,21,24,26,[31][32][33][34][35] Two studies used the average of both arms as the denominator unless the inter-arm BP difference was larger than either 10 mmHg 27 or 15 mmHg 29 , in which case the higher pressure was used. One study only considered the right arm.…”

Section: Doppler Abi Measurementmentioning

confidence: 99%

“…In one study, this analysis led to changing the oscillometric cutoff value for diagnosing PAD from 0.9 to 1.02 in unselected subjects, and to 1.04 in diabetic patients and 1.0 in non-diabetic patients. 7 Kollias et al 19 found that the optimal sensitivity and specificity (92%) is achieved with a cutoff value of 0.97, and Korno et al 32 reported a cutoff value of 0.92 (sensitivity 71% and specificity 92%).…”

Section: Threshold Valuesmentioning

confidence: 99%

“…6,27,28,31,42 Another study reported that the oscillometric device failed to measure BP in three legs from three patients, all of whom had a Doppler ABI o0.90. 19 Some oscillometric devices have been suggested to potentially be unable to determine low BP values, such as o50 mmHg 36 or o30 mmHg. 14 However, the automated oscillometric ABI estimation is simpler and faster than the Doppler ABI measurement, 14,19,21 which makes it more suitable for wide use and mass screening in general practice.…”

Section: Automated Ankle-brachial Index Assessment Wj Verberk Et Almentioning

confidence: 99%

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Automated oscillometric determination of the ankle-brachial index: a systematic review and meta-analysis

2012

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Measurement of the ankle-brachial index (ABI) using a Doppler device is widely used to identify subjects with peripheral artery disease (PAD), and those who are at high risk of cardiovascular disease. This paper presents a systematic review (Medline/ PubMed, Embase and Cochrane) and meta-analysis of studies assessing the usefulness of automated oscillometric devices for ABI estimation and PAD detection compared with the conventional Doppler method. A total of 25 studies including 4186 subjects were analyzed. A random-effects model analysis showed that the average oscillometric ABI was similar to the Doppler ABI (mean difference ± s.e. 0.020 ± 0.018, P ¼ 0.3) but that the absolute differences were significant (0.048 ± 0.009, Po0.01). The pooled correlation coefficient (r) between the oscillometric and Doppler ABI was 0.71 ± 0.05. Simultaneous arm-leg measurements resulted in a smaller difference between the average oscillometric ABI value and the average Doppler ABI value than did sequential measurements ( À0.012 ± 0.022 vs. 0.040 ± 0.026, respectively, Po0.01). The average sensitivity and specificity of the oscillometric ABI estimation in PAD diagnosis was 69 ± 6% and 96 ± 1%, respectively (with Doppler ABI taken as the reference). These data suggest that an automated ABI measurement obtained by oscillometric blood pressure monitors is a reliable and practical alternative to the conventional Doppler measurement for the detection of PAD.To increase the sensitivity of the PAD diagnosis based on an oscillometric ABI, a higher threshold of 1.0 might be preferable.

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Section: Resultsmentioning

confidence: 99%

Section: Methods and Device Type Analysesmentioning

confidence: 93%

Section: Doppler Abi Measurementmentioning

confidence: 99%

Section: Threshold Valuesmentioning

confidence: 99%

Section: Automated Ankle-brachial Index Assessment Wj Verberk Et Almentioning

confidence: 99%

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Automated oscillometric determination of the ankle-brachial index: a systematic review and meta-analysis

2012

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Screening for Peripheral Artery Disease Using the Ankle-Brachial Index

Guirguis-Blake

Evans

Redmond

et al. 2018

JAMA

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IMPORTANCE Peripheral artery disease (PAD) is associated with a high risk for cardiovascular events and poor ambulatory function, even in the absence of symptoms. Screening for PAD with the ankle-brachial index (ABI) may identify patients in need of treatment to improve health outcomes. OBJECTIVE To systematically review evidence for the US Preventive Services Task Force on PAD screening with the ABI, the diagnostic accuracy of the test, and the benefits and harms of treatment of screen-detected PAD.

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Ankle brachial index for the diagnosis of lower limb peripheral arterial disease

Crawford

Welch

Andras

et al. 2016

Cochrane Database of Systematic Reviews

105

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Background Peripheral arterial disease (PAD) of the lower limb is common, with prevalence of both symptomatic and asymptomatic disease estimated at 13% in the over 50 age group. Symptomatic PAD affects about 5% of individuals in Western populations between the ages of 55 and 74 years. The most common initial symptom of PAD is muscle pain on exercise that is relieved by rest and is attributed to reduced lower limb blood flow due to atherosclerotic disease (intermittent claudication). The ankle brachial index (ABI) is widely used by a variety of healthcare professionals, including specialist nurses, physicians, surgeons and podiatrists working in primary and secondary care settings, to assess signs and symptoms of PAD. As the ABI test is non-invasive and inexpensive and is in widespread clinical use, a systematic review of its diagnostic accuracy in people presenting with leg pain suggestive of PAD is highly relevant to routine clinical practice. Objectives To estimate the diagnostic accuracy of the ankle brachial index (ABI)-also known as the ankle brachial pressure index (ABPI)-for the diagnosis of peripheral arterial disease in people who experience leg pain on walking that is alleviated by rest. Search methods We carried out searches of the following databases in August 2013: MEDLINE (Ovid SP),Embase (Ovid SP), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO), Latin American and Caribbean Health Sciences (LILACS) (Bireme),

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Automated determination of the ankle-brachial index using an oscillometric blood pressure monitor: validation vs. Doppler measurement and cardiovascular risk factor profile

Cited by 58 publications

References 25 publications

Automated oscillometric determination of the ankle-brachial index: a systematic review and meta-analysis

Automated oscillometric determination of the ankle-brachial index: a systematic review and meta-analysis

Screening for Peripheral Artery Disease Using the Ankle-Brachial Index

Ankle brachial index for the diagnosis of lower limb peripheral arterial disease

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