Diagnostic Accuracy of Ankle-Brachial Pressure Index Compared with Doppler Arterial Waveforms for Detecting Peripheral Arterial Disease: A Systematic Review.
Journal
Advances in skin & wound care
ISSN: 1538-8654
Titre abrégé: Adv Skin Wound Care
Pays: United States
ID NLM: 100911021
Informations de publication
Date de publication:
01 Apr 2022
01 Apr 2022
Historique:
entrez:
21
3
2022
pubmed:
22
3
2022
medline:
24
3
2022
Statut:
ppublish
Résumé
To present the results of a research study evaluating the diagnostic accuracy of the ankle-brachial pressure index (ABPI) compared with that of Doppler arterial waveforms (DAWs) to detect peripheral arterial disease (PAD). This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After completing this continuing education activity, the participant will:1. Summarize the evidence the authors considered when comparing the diagnostic accuracy of the ABPI with that of Doppler arterial waveforms to detect PAD.2. Select the characteristics of the participants in the studies the authors analyzed.3. Identify the results of the authors' study comparing the diagnostic accuracy of the ABPI with that of Doppler arterial waveforms to detect PAD.4. Distinguish the authors' conclusions about the advantages of using Doppler arterial waveforms to detect PAD. Although the ankle-brachial pressure index (ABPI) is a useful tool for the noninvasive assessment of peripheral arterial disease (PAD), it has several limitations necessitating alternative noninvasive diagnostic tools. This study assesses the diagnostic accuracy of ABPI compared with Doppler arterial waveforms (DAWs) to detect PAD. The authors searched Embase and MEDLINE for original studies that reported sensitivities and specificities for both the ABPI and DAW. Four studies were included representing 657 patients (58.8% men) with a mean age of 63.4 years. The authors detected overall higher sensitivities using DAW compared with ABPI but higher specificities with ABPI compared with DAW. In conclusion, because of the higher sensitivity and lower specificity of DAW compared with ABPI, the authors recommend DAW as a potential screening tool for PAD. To confirm these results, larger sample sizes and comparative trials with homogeneous reference standards and patient populations are required. In addition, DAW is not easily documented for everyday bedside practice in the community. With COVID-19 restrictions, an audible handheld Doppler signal may act as a reproducible equivalent to DAW and thus facilitate timely, safe application of compression therapy at point-of-care.
Autres résumés
Type: plain-language-summary
(eng)
Although the ankle-brachial pressure index (ABPI) is a useful tool for the noninvasive assessment of peripheral arterial disease (PAD), it has several limitations necessitating alternative noninvasive diagnostic tools. This study assesses the diagnostic accuracy of ABPI compared with Doppler arterial waveforms (DAWs) to detect PAD. The authors searched Embase and MEDLINE for original studies that reported sensitivities and specificities for both the ABPI and DAW. Four studies were included representing 657 patients (58.8% men) with a mean age of 63.4 years. The authors detected overall higher sensitivities using DAW compared with ABPI but higher specificities with ABPI compared with DAW. In conclusion, because of the higher sensitivity and lower specificity of DAW compared with ABPI, the authors recommend DAW as a potential screening tool for PAD. To confirm these results, larger sample sizes and comparative trials with homogeneous reference standards and patient populations are required. In addition, DAW is not easily documented for everyday bedside practice in the community. With COVID-19 restrictions, an audible handheld Doppler signal may act as a reproducible equivalent to DAW and thus facilitate timely, safe application of compression therapy at point-of-care.
Identifiants
pubmed: 35311767
doi: 10.1097/01.ASW.0000822628.82131.1d
pii: 00129334-202204000-00004
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Pagination
195-201Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Références
Hirsch AT, Haskal ZJ, Hertzer NR, et al. ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): executive summary. Circulation 2006;113:1474–547.
Rajabi-Estarabadi A, Kayssi A, Alavi A, Kirsner RS. Vascular tests for dermatologists. Am J Clin Dermatol 2019;20:657–67.
Giddings AEB, Loosemore T. Regarding “practice guidelines: lower extremity revascularization”. J Vasc Surg 1994;20:489–90.
Sigvant B, Lundin F, Wahlberg E. The risk of disease progression in peripheral arterial disease is higher than expected: a meta-analysis of mortality and disease progression in peripheral arterial disease. Eur J Vasc Endovasc Surg 2016;51:395–403.
Williams DT, Harding KG, Price P. An evaluation of the efficacy of methods used in screening for lower-limb arterial disease in diabetes. Diabetes Care 2005;28:2206–10.
Gerhard-Herman MD, Gornik HL, Barrett C, et al. 2016 AHA/ACC Guideline on the management of patients with lower extremity peripheral artery disease: executive summary: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Circulation 2017;135:e686–e725.
Babaei MR, Malek M, Rostami FT, Emami Z, Madani NH, Khamseh ME. Non-invasive vascular assessment in people with type 2 diabetes: diagnostic performance of plethysmographic-and-Doppler derived ankle brachial index, toe brachial index, and pulse volume wave analysis for detection of peripheral arterial disease. Prim Care Diabetes 2020;14:282–9.
Crawford F, Welch K, Andras A, Chappell FM. Ankle brachial index for the diagnosis of lower limb peripheral arterial disease. Cochrane Database Syst Rev 2016;9:CD010680.
Scott J, Lecouturier J, Rousseau N, et al. Nurses’ and patients’ experiences and preferences of the ankle-brachial pressure index and multi-site photoplethysmography for the diagnosis of peripheral arterial disease: a qualitative study. PLoS One 2019;14:e0224546.
Al-Qaisi M, Nott DM, King DH, Kaddoura S. Ankle Brachial Pressure Index (ABPI): an update for practitioners. Vasc Health Risk Manag 2009;5:833–41.
Perciun R. Ankle brachial pressure index, value and limitations considerations about its applicability for diabetic individuals. Rom J Diabetes Nutr Metab Dis 2011;18:105–10.
Allen J, Oates CP, Henderson J, et al. Comparison of lower limb arterial assessments using color-duplex ultrasound and ankle/brachial pressure index measurements. Angiology 1996;47:225–32.
Nicolaï SPA, Kruidenier LM, Rouwet EV., El Bartelink ML, Prins MH, Teijink JAW. Ankle brachial index measurement in primary care: are we doing it right?Br J Gen Pract 2009;59:422–7.
Davies JH, Kenkre J, Williams EM. Current utility of the ankle-brachial index (ABI) in general practice: implications for its use in cardiovascular disease screening. BMC Fam Pract 2014;15:69.
Aboyans V, Criqui MH, Abraham P, et al. Measurement and interpretation of the Ankle-Brachial Index: a scientific statement from the American Heart Association. Circulation 2012;126:2890–909.
Mahé G, Boulon C, Desormais I, et al. Statement for Doppler waveforms analysis. Vasa Eur J Vasc Med 2017;46:337–45.
Lewis JE, Williams P, Davies JH. Non-invasive assessment of peripheral arterial disease: automated Ankle Brachial Index measurement and pulse volume analysis compared to duplex scan. SAGE Open Med 2016;4:2050312116659088.
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097.
Bachmann LM, Jüni P, Reichenbach S, Ziswiler HR, Kessels AG, Vögelin E. Consequences of different diagnostic “gold standards” in test accuracy research: carpal tunnel syndrome as an example. Int J Epidemiol 2005;34:953–5.
Institute of Medicine Committee on Social Security Cardiovascular Disability Criteria. Peripheral artery disease. In: Cardiovascular Disability: Updating the Social Security Listings. Washington, DC: National Academies Press; 2010.
Phillips B, Ball C, Sackett D, Badenoch D, Straus S, Haynes B. Oxford Centre for Evidence-based Medicine - Levels of Evidence (March 2009). Centre for Evidence-based Medicine. March 2009. www.cebm.ox.ac.uk/resources/levels-of-evidence/oxford-centre-for-evidence-based-medicine-levels-of-evidence-march-2009 . Last accessed January 18, 2022.
Whiting PF, Rutjes AWS, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 2011;155:529–36.
Ro DH, Moon HJ, Kim JH, Lee KM, Kim SJ, Lee DY. Peripheral arterial disease photoplethysmography and continuous-wave doppler ultrasound as a complementary test to ankle-brachial index in detection of stenotic peripheral arterial disease. Angiology 2013;64:314–20.
Maxim LD, Niebo R, Utell MJ. Screening tests: a review with examples. Inhal Toxicol 2014;26:811–28.
Xu D, Li J, Zou L, et al. Sensitivity and specificity of the ankle-brachial index to diagnose peripheral artery disease: a structured review. Vasc Med 2010;15:361–9.
Rac-Albu M, Iliuta L, Guberna SM, Sinescu C. The role of ankle-brachial index for predicting peripheral arterial disease. Maedica (Buchar) 2014;9:295–302.
Davies JH, Jane A Lewis BE, Mark Williams E. The utility of pulse volume waveforms in the identification of lower limb arterial insufficiency. EWMA J 2014;14:21–5.
Kalish J, Nguyen T, Hamburg N, Eberhardt R, Farber A. The postexercise common femoral artery doppler waveform: a powerful noninvasive vascular laboratory test to exclude aortoiliac disease. J Vasc Ultrasound 2012;36:249–53.
Scissons R, Comerota A. Confusion of peripheral arterial doppler waveform terminology. JDMS 2009;25:185–94.
Sibley RG III, Reis SP, MacFarlane JJ, Reddick MA, Kalva SP, Sutphin PD. Noninvasive physiologic vascular studies: a guide to diagnosing peripheral arterial disease. RadioGraphics 2017;37:346–57.
Scissons R. Characterizing triphasic, biphasic, and monophasic Doppler waveforms: should a simple task be so difficult?J Diagnostic Med Sonogr 2008;24:269–76.
Baker AR, Evans DH, Macpherson DS, Bell PR. Doppler waveform analysis in the management of lower limb arterial disease. Ann R Coll Surg Engl 1986;68:103–6.
Alavi A, Sibbald RG, Nabavizadeh R, Valaei F, Coutts P, Mayer D. Audible handheld Doppler ultrasound determines reliable and inexpensive exclusion of significant peripheral arterial disease. Vascular 2015;23:622–9.