Comparison of ankle brachial pressure index to arterial doppler USG in the diagnosis of peripheral vascular disease in diabetes mellitus

Gupta, Abhishek; Tyagi, V. K.; Bansal, Neelam; Virmani, S. K.; Sirohi, Tanuraj

doi:10.18203/2349-3933.ijam20175135

Cited by 7 publications

(12 citation statements)

References 5 publications

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“…Sensitivity of ABI was found to be 92.5%, Specificity - 88.33%, Positive Predictive Value (PPV) - 84.09% and Negative Predictive Value (NPV) - 94.64%, respectively. [ 15 ] The sensitivity of ABI measurement in comparison to DUS was found to be 88.89% and specificity 90.48% in the present study, similar to previous studies.…”

Section: Discussionsupporting

confidence: 91%

Use of ABI to detect peripheral arterial disease in diabetes – A recommendation for primary care physicians

Mishra

2021

Journal of Family Medicine and Primary Care

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Background: India is considered the diabetes capital of the world. As per current practice, most of the diabetes patients go to primary care physicians for their monitoring and follow up. One of the dreaded complications of long-term diabetes is peripheral arterial disease. Methods: A cross-sectional observational study was conducted in a diabetes workshop. Totally, 48 patients were selected who satisfied the inclusion criteria. All were subjected to ankle-brachial index measurement (ABI) and doppler ultrasound was done to assess patency of the lower extremity arteries. The results were compared. The ankle-brachial index of less than 0.99 was considered abnormal. Results: Out of a total of 48 included patients 26 patients had normal ABI and 22 patients were found to have abnormal ABI. Out of those with normal ABI, 2 patients had features of peripheral arterial disease proved by doppler, whereas 3 patients with abnormal ABI had no feature of peripheral arterial disease in doppler. MedCalc software was used for statistical comparison. Conclusion: In the selected diabetic population prevalence of peripheral arterial disease was found to be 56.25%. Measurement of ABI was found to be quite a sensitive and specific method for diagnosing peripheral arterial disease of diabetics.

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Section: Discussionsupporting

confidence: 91%

Use of ABI to detect peripheral arterial disease in diabetes – A recommendation for primary care physicians

Mishra

2021

Journal of Family Medicine and Primary Care

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“…Fourteen studies were retrospective [10][11][12][14][15][16][17]22,29,[33][34][35][36][37] and 19 were prospective. 13,[18][19][20][21][23][24][25][26][27][28][30][31][32][38][39][40][41][42]…”

Section: Resultsmentioning

confidence: 99%

“…For studies using CDUS, 15 of the 21 identified studies [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] reported the requisite data to perform the bivariate meta-analysis (sensitivity, specificity, number of participants with and without PAD) (Table S4). Mean sensitivity and specificity, DOR, ROC curve and AUC were calculated.…”

Section: What's New?mentioning

confidence: 99%

“…Some studies used the highest ankle pressure divided by the highest brachial pressure, 10,12,22,24,[28][29][30]41 whereas others reported multiple methods of calculating the ABI using: the lowest, highest and/or average of both ankle pressures; 14,17,34 the lowest ankle pressure; 11,18 an average of two ankle pressures 19,21,26 or did not specify which ankle pressures were used; 13,35,42 the highest ankle pressure divided by the brachial pressure from the same side or a single brachial pressure; 16,27,31,38 or single ankle pressure. 25 There was insufficient reporting to determine the method used to calculate the ABI in nine studies 15,20,23,25,33,36,37,39,40 (Tables 1 and 2).…”

Section: Assessment Of the Abimentioning

confidence: 99%

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Estimating the diagnostic accuracy of the ankle–brachial pressure index for detecting peripheral arterial disease in people with diabetes: A systematic review and meta‐analysis

et al. 2020

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Aim To systematically evaluate research investigating the accuracy of the ankle–brachial index (ABI) for diagnosing peripheral artery disease (PAD) in people with diabetes, as the accuracy is thought to be reduced in this cohort. Methods A database search of EBSCO Megafile Premier, Embase and The Cochrane Library was conducted to 28 February 2019. Prospective and retrospective investigations of the diagnostic accuracy of the ABI for PAD in people with diabetes using an imaging reference standard were eligible. Sensitivity and specify of the ABI and bivariate meta‐analysis against reference tests, or a standard summary receiver operating curve analysis (SROC) was performed. Results Thirty‐three studies met the inclusion criteria. ABI was compared with angiography in 12 studies and with colour duplex ultrasound (CDUS) in 21 studies. A SROC analysis of studies using angiography as the reference standard found a diagnostic odds ratio (DOR) of 9.06 [95% confidence interval (CI) 3.61 to 22.69], and area under the curve (AUC) of 0.76 (95% CI 0.66 to 0.86). Bivariate analysis of studies using CDUS demonstrated mean sensitivity of 0.60 (95% CI 0.48 to 0.71; P = 0.097) and mean specificity of 0.87 (95% CI 0.78 to 0.92; P < 0.001) with a DOR of 9.76 (95% CI 5.24 to 18.20; P < 0.0001) and AUC 0.72. Conclusions These results suggest the ABI has a high specificity but lower sensitivity in detecting imaging diagnosed PAD in people with diabetes. The low probability of the testing being able to rule diagnosis in or out suggest that the ABI has limited effectiveness for early detection of PAD in this cohort.

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“…Diabetic patients who have end-stage renal disease also show normal or falsely elevated ABI. Therefore, using their data nullifies the value of the test for diagnosis and follow-up [12].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Color Doppler Ultrasound and Ankle-Brachial Pressure Index Measurement in Peripheral Vascular Diseases

et al. 2020

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Peripheral vascular diseases (PVD) are a group of common degenerative (organic) and vasospastic (functional) disease processes that result in significant morbidity and are strong predictors of subsequent mortality. It is diagnosed by definitive history of intermittent claudication or if one or more of peripheral pulses are absent in one or both lower limbs. A variety of non-invasive techniques, viz., ankle-brachial pressure index (ABPI) test and color Doppler imaging, are available to diagnose the presence of PVD as well as to localize areas of stenosis, assess severity of disease, and follow patients for disease progression or response to therapy. Therefore, the focus of this study is to compare color Doppler ultrasound and ABPI individually and in combination in diagnosing cases of peripheral vascular diseases, considering CT angiography the gold standard investigation. Patients were assessed on the basis of history; clinical examination and relevant investigations done were noted in the data sheet according to the proforma including the Edinburgh Claudication Questionnaire. Comparison of color Doppler ultrasound and ankle-brachial pressure index measurement in peripheral vascular diseases was determined using relevant statistical tests. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for comparison of ABPI and color Doppler imaging with CT angiography. Color Doppler ultrasound proved to be a better modality as compared to the anklebrachial pressure index for diagnosis of peripheral vascular disease, considering CT angiography the gold standard investigation.

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Comparison of ankle brachial pressure index to arterial doppler USG in the diagnosis of peripheral vascular disease in diabetes mellitus

Cited by 7 publications

References 5 publications

Use of ABI to detect peripheral arterial disease in diabetes – A recommendation for primary care physicians

Use of ABI to detect peripheral arterial disease in diabetes – A recommendation for primary care physicians

Estimating the diagnostic accuracy of the ankle–brachial pressure index for detecting peripheral arterial disease in people with diabetes: A systematic review and meta‐analysis

Comparison of Color Doppler Ultrasound and Ankle-Brachial Pressure Index Measurement in Peripheral Vascular Diseases

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