Non-invasive vascular assessment in the foot with diabetes: sensitivity and specificity of the ankle brachial index, toe brachial index and continuous wave Doppler for detecting peripheral arterial disease

Tehan, Peta Ellen; Bray, Abigail; Chuter, Vivienne

doi:10.1016/j.jdiacomp.2015.07.019

Cited by 74 publications

(108 citation statements)

References 28 publications

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“…6 The similar performance of this test in the diabetes group compared to the no diabetes group may be due to the fact that CWD appears to have higher sensitivity in more severe disease groups. This is typically found more frequently in diabetes populations, 3,6 and this was the case in this diabetes cohort in this study, where the majority of PAD was occlusive.…”

Section: Discussionsupporting

confidence: 65%

“…These results indicate that CWD is unlikely to result in a false diagnosis of PAD, consistent with previous findings. 3,6 Negative likelihood ratios approximately 0.20 in both groups indicate that a negative CWD result is associated with a moderate decrease in probability of PAD. 16 Investigation of the sensitivity of CWD for PAD by severity and location of disease identified several potential limitations of this form of assessment.…”

Section: Discussionmentioning

confidence: 96%

“…There is initial evidence in a small community-based sample with diabetes suggesting CWD may have high diagnostic accuracy for PAD. 3 However, the diagnostic accuracy of CWD for PAD has been relatively underexplored in either the general population or diabetes cohorts. The primary aim of this study was to determine sensitivity and specificity of CWD for detecting lower limb PAD in a population suspected to have the disease.…”

Section: Introductionmentioning

confidence: 99%

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How sensitive and specific is continuous-wave Doppler for detecting peripheral arterial disease in people with and without diabetes? A cross-sectional study

Tehan

Sebastian

Barwick

et al. 2018

Diabetes and Vascular Disease Research

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Background: Continuous-wave Doppler is frequently used for detecting peripheral arterial disease in patients with diabetes; however, there is limited evidence investigating diagnostic accuracy. This study aimed to determine sensitivity and specificity of continuous-wave Doppler for detecting peripheral arterial disease in populations with, and without, diabetes and to investigate the influence of disease severity on sensitivity of continuous-wave Doppler for detecting peripheral arterial disease. Results: Data from 396 participants were included. Using colour Duplex ultrasound as reference standard (N=66), printed continuous-wave Doppler waveform analysis sensitivity was 81.75% (95% confidence interval: 76.75 to 85.88) and specificity 89.34% (95% confidence interval: 82.62 to 93.67). Printed continuous-wave Doppler waveform analysis sensitivity for peripheral arterial disease was comparable to sensitivity calculated using angiography as the reference standard (81.67%; 95% confidence interval: 69.56 to 90.48). Sensitivity and specificity were unaffected by diabetes diagnosis (n = 176), sensitivity 82.76% (95% confidence interval: 74.86 to 88.55), and specificity 88.33% (95% confidence interval: 77.82 to 94.23). Conclusion: Continuous-wave Doppler is a fair assessment tool for peripheral arterial disease in a community-based sample with suspected peripheral arterial disease. Diagnostic accuracy of continuous-wave Doppler for peripheral arterial disease is unaffected by the presence of diabetes.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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How sensitive and specific is continuous-wave Doppler for detecting peripheral arterial disease in people with and without diabetes? A cross-sectional study

Tehan

Sebastian

Barwick

et al. 2018

Diabetes and Vascular Disease Research

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View full text Add to dashboard Cite

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“…As these patients would be the patient population that may benefit from a more accurate measurement. The other limitation of this study is, to prove ABI-d is comparable or reliable measure to ABI-s we could compare the automated boso ABI machine measurement to a mercury sphygmomanometer and continuous Doppler device [25]. This would have prolonged the time of the examination and the major aim of the study was to obtain the ABI-s and ABI-d values for comparison between all the groups and further studies are need to explore this issue.…”

Section: Discussionmentioning

confidence: 99%

Diastolic versus systolic ankle-brachial pressure index using ultrasound imaging & automated oscillometric measurement in diabetic patients with calcified and non-calcified lower limb arteries

Asbeutah

Almajran

Asfar

2016

BMC Cardiovasc Disord

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BackgroundAnkle-brachial pressure index-systolic (ABI-s) can be falsely elevated in the presence of calcified lower limb arteries in some diabetic patients and therefore loses its value in this cohort of patients. We aim at investigating the feasibility of using the diastolic (ABI-d) instead of ABI-s to calculate the ABI in diabetic patients with calcified limb arteries.MethodsA total of 51 patients were chosen from the diabetic foot clinic. Twenty six of these patients had calcified leg arteries by Duplex scan (Group A) and 25 patients did not have calcifications in their leg arteries (Group B). Twenty five healthy volunteers were enrolled in the study for group C and they were matched with other participants from group B and A in age and sex. ABI measurement was performed using “boso ABI-system 100 machine”. Systolic ABI (ABI-s) and diastolic ABI (ABI-d) were calculated based on bilateral brachial and ankle oscillometric pressures. ABI is considered normal when it is ≥0.9. Repeated measures ANOVA test was used to test for comparing mean scores for ABI-s and ABI-d across the three groups. Statistical significance is considered when P < .05.ResultsThe mean age of all participants (±SD) was 64.30 ± 7.1 years (range, 50–82 years). ABI-s mean ± SD was 1.3 ± 0.10 (range, 1.18–1.58) in group A patients, 1.07 ± 0.05 (range, 1–1.16) in group B patients, and 1.06 ± 0.05 (range, 1–1.16) in group C volunteers. While ABI-d mean ± SD was 1.07 ± 0.05 (range, 1.1–1.17) in group A patients, 1.06 ± 0.05 (1–1.14) in group B patients, and 1.05 ± 0.04 (range, 1.01–1.14) in group C volunteers. In group A, repeated measures ANOVA test showed statistical significant difference between ABI-s and ABI-d (P < 0.001) whereas in group B & C was not (P > 0.05).ConclusionsABI-d may be helpful and can be used as a complementary measure instead of ABI-s in falsely elevated ABI caused by partial incompressible vessel.

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“…A Doppler-hullám spektrumelemzése a perifériás érbe-tegség kimutatásának hatékony eszköze a cukorbeteg populációban [23].…”

Section: áBra Artériás Doppler-görbék Típusaiunclassified

A diabeteses láb ischaemiás eredete. Epidemiológia, a diagnózis nehézségei, prevenciós és revascularisatiós lehetőségek

et al. 2017

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A "diabeteses láb" mint multifaktoriális megbetegedés hátterében a neuropathia, infekció, csont-és lágyrész-eltérések mellett a legutóbbi évek epidemiológiai adatai alapján az alsó végtagi ischaemia szerepe egyre inkább hangsúlyossá válik. Cukorbetegségben az alsó végtagi ütőérszűkület rendkívüli mértékben fokozza az alsó végtagi fekélyképződés, valamint a minor és major amputáció kockázatát. A diabetesre jellemző klinikai megjelenés miatt az alsó végtagi ütő-érszűkület felismerésére a hagyományos diagnosztikus eljárások korlátozottan alkalmazhatók. A hatékony diagnosztika alapfeltétele olyan vascularis központok elérhetősége, amelyek a szakmai ismeretek és rendelkezésre álló diagnosztikus eszközök segítségével alkalmasak a cukorbetegcsoportban az érbetegség időben történő detektálására. Az ischaemiás kórokra visszavezethető diabeteses láb kezelése során a hatékony gyógyszeres kezelés mellett az érát-járhatóság helyreállításának kiemelt fontosságot tulajdonítanak. Az érsebészeti és intervenciós radiológiai beavatkozá-sok sikeresen előzhetik meg a végtagvesztést. Népegészségügyi érdek, hogy kiemelt vascularis centrumok alakuljanak, ahol az angiológusok, érsebészek, intervenciós radiológusok csoportjai a társszakmákkal együttműködve lehetnek képesek multidiszciplináris módon az érbetegségek magas szintű szakmai ellátására. Orv. Hetil., 2017, 158(6), 203-211. Kulcsszavak: diabeteses láb, perifériás érbetegség, alsó végtagi amputációIschemic origin of diabetic foot disease. Epidemiology, difficulties of diagnosis, options for prevention and revascularization "Diabetic foot" as definition covers a multifactorial clinical condition. According to the recent epidemiological data, the role of lower limb ischemia is getting more influential over other pathological causes, like neuropathy, infections and bone or soft tissue deformity. In diabetes, vascular disease leads to increased risk for leg ulcers and minor or major amputations. The traditional diagnostic tools for recognition of peripheral arterial disease have limited value because of diabetes specific clinical manifestations. Available vascular centers with special expertise and diagnostic tools are the prerequisite for efficient diagnosis supporting timely recognition of peripheral arterial disease. In course of treatment of diabetic foot with ischemic origin, beyond effective medical treatment revascularization (open vascular surgery or endovascular procedures) has paramount importance for prevention of limb loss. Vascular teams of vascular specialists, vascular surgeons and interventional radiologist in dedicated centers in multidisciplinary cooperation with other professions represent public health issue in effective prevention.

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Non-invasive vascular assessment in the foot with diabetes: sensitivity and specificity of the ankle brachial index, toe brachial index and continuous wave Doppler for detecting peripheral arterial disease

Cited by 74 publications

References 28 publications

How sensitive and specific is continuous-wave Doppler for detecting peripheral arterial disease in people with and without diabetes? A cross-sectional study

How sensitive and specific is continuous-wave Doppler for detecting peripheral arterial disease in people with and without diabetes? A cross-sectional study

Diastolic versus systolic ankle-brachial pressure index using ultrasound imaging & automated oscillometric measurement in diabetic patients with calcified and non-calcified lower limb arteries

A diabeteses láb ischaemiás eredete. Epidemiológia, a diagnózis nehézségei, prevenciós és revascularisatiós lehetőségek

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