Non-invasive assessment of peripheral arterial disease: Automated ankle brachial index measurement and pulse volume analysis compared to duplex scan
Identifieur interne : 008663 ( Ncbi/Merge ); précédent : 008662; suivant : 008664Non-invasive assessment of peripheral arterial disease: Automated ankle brachial index measurement and pulse volume analysis compared to duplex scan
Auteurs : Jane Ea Lewis [Royaume-Uni] ; Paul Williams [Royaume-Uni] ; Jane H. Davies [Royaume-Uni]Source :
- SAGE Open Medicine [ 2050-3121 ] ; 2016.
Abstract
This cross-sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (1) ankle brachial index and (2) pulse volume waveform analysis recorded by the same automated device, with the presence or absence of peripheral arterial disease being verified by ultrasound duplex scan.
Patients (n=205) referred for lower limb arterial assessment underwent ankle brachial index measurement and pulse volume waveform recording using volume plethysmography, followed by ultrasound duplex scan. The presence of peripheral arterial disease was recorded if ankle brachial index <0.9; pulse volume waveform was graded as 2, 3 or 4; or if haemodynamically significant stenosis >50% was evident with ultrasound duplex scan. Outcome measure was agreement between the measured ankle brachial index and interpretation of pulse volume waveform for peripheral arterial disease diagnosis, using ultrasound duplex scan as the reference standard.
Sensitivity of ankle brachial index was 79%, specificity 91% and overall accuracy 88%. Pulse volume waveform sensitivity was 97%, specificity 81% and overall accuracy 85%. The combined sensitivity of ankle brachial index and pulse volume waveform was 100%, specificity 76% and overall accuracy 85%.
Combining these two diagnostic modalities within one device provided a highly accurate method of ruling out peripheral arterial disease, which could be utilised in primary care to safely reduce unnecessary secondary care referrals.
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DOI: 10.1177/2050312116659088
PubMed: 27493755
PubMed Central: 4959301
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Davies</name><affiliation wicri:level="1"><nlm:aff id="aff3-2050312116659088">South East Wales Trials Unit, Cardiff University, Cardiff, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>South East Wales Trials Unit, Cardiff University, Cardiff</wicri:regionArea><wicri:noRegion>Cardiff</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27493755</idno><idno type="pmc">4959301</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4959301</idno><idno type="RBID">PMC:4959301</idno><idno type="doi">10.1177/2050312116659088</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000854</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000854</idno><idno type="wicri:Area/Pmc/Curation">000854</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000854</idno><idno type="wicri:Area/Pmc/Checkpoint">000751</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000751</idno><idno type="wicri:Area/Ncbi/Merge">008663</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Non-invasive assessment of peripheral arterial disease: Automated ankle brachial index measurement and pulse volume analysis compared to duplex scan</title><author><name sortKey="Lewis, Jane Ea" sort="Lewis, Jane Ea" uniqKey="Lewis J" first="Jane Ea" last="Lewis">Jane Ea Lewis</name><affiliation wicri:level="1"><nlm:aff id="aff1-2050312116659088">Cardiff School of Health Sciences, Cardiff Metropolitan University, Cardiff, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Cardiff School of Health Sciences, Cardiff Metropolitan University, Cardiff</wicri:regionArea><wicri:noRegion>Cardiff</wicri:noRegion></affiliation></author><author><name sortKey="Williams, Paul" sort="Williams, Paul" uniqKey="Williams P" first="Paul" last="Williams">Paul Williams</name><affiliation wicri:level="1"><nlm:aff id="aff2-2050312116659088">Department of Medical Physics, University Hospital of Wales, Cardiff, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Medical Physics, University Hospital of Wales, Cardiff</wicri:regionArea><wicri:noRegion>Cardiff</wicri:noRegion></affiliation></author><author><name sortKey="Davies, Jane H" sort="Davies, Jane H" uniqKey="Davies J" first="Jane H" last="Davies">Jane H. Davies</name><affiliation wicri:level="1"><nlm:aff id="aff3-2050312116659088">South East Wales Trials Unit, Cardiff University, Cardiff, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>South East Wales Trials Unit, Cardiff University, Cardiff</wicri:regionArea><wicri:noRegion>Cardiff</wicri:noRegion></affiliation></author></analytic><series><title level="j">SAGE Open Medicine</title><idno type="eISSN">2050-3121</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="section1-2050312116659088"><title>Objectives:</title><p>This cross-sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (1) ankle brachial index and (2) pulse volume waveform analysis recorded by the same automated device, with the presence or absence of peripheral arterial disease being verified by ultrasound duplex scan.</p></sec><sec id="section2-2050312116659088"><title>Methods:</title><p>Patients (n=205) referred for lower limb arterial assessment underwent ankle brachial index measurement and pulse volume waveform recording using volume plethysmography, followed by ultrasound duplex scan. The presence of peripheral arterial disease was recorded if ankle brachial index <0.9; pulse volume waveform was graded as 2, 3 or 4; or if haemodynamically significant stenosis >50% was evident with ultrasound duplex scan. Outcome measure was agreement between the measured ankle brachial index and interpretation of pulse volume waveform for peripheral arterial disease diagnosis, using ultrasound duplex scan as the reference standard.</p></sec><sec id="section3-2050312116659088"><title>Results:</title><p>Sensitivity of ankle brachial index was 79%, specificity 91% and overall accuracy 88%. Pulse volume waveform sensitivity was 97%, specificity 81% and overall accuracy 85%. The combined sensitivity of ankle brachial index and pulse volume waveform was 100%, specificity 76% and overall accuracy 85%.</p></sec><sec id="section4-2050312116659088"><title>Conclusion:</title><p>Combining these two diagnostic modalities within one device provided a highly accurate method of ruling out peripheral arterial disease, which could be utilised in primary care to safely reduce unnecessary secondary care referrals.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Fowkes, Fgr" uniqKey="Fowkes F">FGR Fowkes</name></author><author><name sortKey="Rudan, D" uniqKey="Rudan D">D Rudan</name></author><author><name sortKey="Rudan, I" uniqKey="Rudan I">I Rudan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tendera, M" uniqKey="Tendera M">M Tendera</name></author><author><name sortKey="Aboyans, V" uniqKey="Aboyans V">V Aboyans</name></author><author><name sortKey="Bartelink, Ml" uniqKey="Bartelink M">ML Bartelink</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fowkes, Fgr" uniqKey="Fowkes F">FGR Fowkes</name></author><author><name sortKey="Murray, Gd" uniqKey="Murray G">GD Murray</name></author><author><name sortKey="Butcher, I" uniqKey="Butcher I">I Butcher</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hirsch, At" uniqKey="Hirsch A">AT Hirsch</name></author><author><name sortKey="Haskal, Zj" uniqKey="Haskal Z">ZJ Haskal</name></author><author><name sortKey="Hertzer, Nr" uniqKey="Hertzer N">NR Hertzer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jaipersad, As" uniqKey="Jaipersad A">AS Jaipersad</name></author><author><name sortKey="Silverman, Sh" uniqKey="Silverman S">SH Silverman</name></author><author><name sortKey="Lip, Gyh" uniqKey="Lip G">GYH Lip</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Norgren, L" uniqKey="Norgren L">L Norgren</name></author><author><name sortKey="Hiatt, Wr" uniqKey="Hiatt W">WR Hiatt</name></author><author><name sortKey="Dormand, Ja" uniqKey="Dormand J">JA Dormand</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nicolai, Sp" uniqKey="Nicolai S">SP Nicolaï</name></author><author><name sortKey="Kruidenier, Lm" uniqKey="Kruidenier L">LM Kruidenier</name></author><author><name sortKey="Rouwet, Ev" uniqKey="Rouwet E">EV Rouwet</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Davies, Jh" uniqKey="Davies J">JH Davies</name></author><author><name sortKey="Kenkre, J" uniqKey="Kenkre J">J Kenkre</name></author><author><name sortKey="Williams, Em" uniqKey="Williams E">EM Williams</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mohler, Er" uniqKey="Mohler E">ER Mohler</name></author><author><name sortKey="Treat Jacobson, D" uniqKey="Treat Jacobson D">D Treat-Jacobson</name></author><author><name sortKey="Reilly, Mp" uniqKey="Reilly M">MP Reilly</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Verberk, Wj" uniqKey="Verberk W">WJ Verberk</name></author><author><name sortKey="Kollias, A" uniqKey="Kollias A">A Kollias</name></author><author><name sortKey="Stergiou, Gs" uniqKey="Stergiou G">GS Stergiou</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Anderson, Jl" uniqKey="Anderson J">JL Anderson</name></author><author><name sortKey="Halperin, Jl" uniqKey="Halperin J">JL Halperin</name></author><author><name sortKey="Albert, Nm" uniqKey="Albert N">NM Albert</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Davies, Jh" uniqKey="Davies J">JH Davies</name></author><author><name sortKey="Lewis, Jea" uniqKey="Lewis J">JEA Lewis</name></author><author><name sortKey="Williams, Em" uniqKey="Williams E">EM Williams</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rumwell, C" uniqKey="Rumwell C">C Rumwell</name></author><author><name sortKey="Mcpharlin, M" uniqKey="Mcpharlin M">M McPharlin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gerhard Herman, M" uniqKey="Gerhard Herman M">M Gerhard-Herman</name></author><author><name sortKey="Gardin, Jm" uniqKey="Gardin J">JM Gardin</name></author><author><name sortKey="Jaff, M" uniqKey="Jaff M">M Jaff</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Altman, Dg" uniqKey="Altman D">DG Altman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Williams, Dt" uniqKey="Williams D">DT Williams</name></author><author><name sortKey="Harding, Kg" uniqKey="Harding K">KG Harding</name></author><author><name sortKey="Price, P" uniqKey="Price P">P 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uniqKey="Almeida J">JI Almeida</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Poots, J" uniqKey="Poots J">J Poots</name></author><author><name sortKey="Kennedy, R" uniqKey="Kennedy R">R Kennedy</name></author><author><name sortKey="Dennison, T" uniqKey="Dennison T">T Dennison</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Collins, R" uniqKey="Collins R">R Collins</name></author><author><name sortKey="Burch, J" uniqKey="Burch J">J Burch</name></author><author><name sortKey="Cranny, G" uniqKey="Cranny G">G Cranny</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">SAGE Open Med</journal-id><journal-id journal-id-type="iso-abbrev">SAGE Open Med</journal-id><journal-id journal-id-type="publisher-id">SMO</journal-id><journal-id journal-id-type="hwp">spsmo</journal-id><journal-title-group><journal-title>SAGE Open Medicine</journal-title></journal-title-group><issn pub-type="epub">2050-3121</issn><publisher><publisher-name>SAGE Publications</publisher-name><publisher-loc>Sage UK: London, England</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27493755</article-id><article-id pub-id-type="pmc">4959301</article-id><article-id pub-id-type="doi">10.1177/2050312116659088</article-id><article-id pub-id-type="publisher-id">10.1177_2050312116659088</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Non-invasive assessment of peripheral arterial disease: Automated ankle brachial index measurement and pulse volume analysis compared to duplex scan</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Lewis</surname><given-names>Jane EA</given-names></name><xref ref-type="aff" rid="aff1-2050312116659088">1</xref><xref ref-type="corresp" rid="corresp1-2050312116659088"></xref></contrib><contrib contrib-type="author"><name><surname>Williams</surname><given-names>Paul</given-names></name><xref ref-type="aff" rid="aff2-2050312116659088">2</xref></contrib><contrib contrib-type="author"><name><surname>Davies</surname><given-names>Jane H</given-names></name><xref ref-type="aff" rid="aff3-2050312116659088">3</xref></contrib></contrib-group><aff id="aff1-2050312116659088"><label>1</label>Cardiff School of Health Sciences, Cardiff Metropolitan University, Cardiff, UK</aff><aff id="aff2-2050312116659088"><label>2</label>Department of Medical Physics, University Hospital of Wales, Cardiff, UK</aff><aff id="aff3-2050312116659088"><label>3</label>South East Wales Trials Unit, Cardiff University, Cardiff, UK</aff><author-notes><corresp id="corresp1-2050312116659088">Jane EA Lewis, Cardiff School of Health Sciences, Cardiff Metropolitan University, 200 Western Avenue, Cardiff CF5 2YB, UK. Email: <email>jealewis@Cardiffmet.ac.uk</email></corresp></author-notes><pub-date pub-type="epub"><day>12</day><month>7</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>4</volume><elocation-id>2050312116659088</elocation-id><history><date date-type="received"><day>4</day><month>4</month><year>2016</year></date><date date-type="accepted"><day>14</day><month>6</month><year>2016</year></date></history><permissions><copyright-statement>© The Author(s) 2016</copyright-statement><copyright-year>2016</copyright-year><copyright-holder content-type="sage">SAGE Publications</copyright-holder><license license-type="creative-commons" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (<ext-link ext-link-type="uri" xlink:href="http://www.creativecommons.org/licenses/by-nc/3.0/">http://www.creativecommons.org/licenses/by-nc/3.0/</ext-link>) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(<ext-link ext-link-type="uri" xlink:href="https://us.sagepub.com/en-us/nam/open-access-at-sage">https://us.sagepub.com/en-us/nam/open-access-at-sage</ext-link>).</license-p></license></permissions><abstract><sec id="section1-2050312116659088"><title>Objectives:</title><p>This cross-sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (1) ankle brachial index and (2) pulse volume waveform analysis recorded by the same automated device, with the presence or absence of peripheral arterial disease being verified by ultrasound duplex scan.</p></sec><sec id="section2-2050312116659088"><title>Methods:</title><p>Patients (n=205) referred for lower limb arterial assessment underwent ankle brachial index measurement and pulse volume waveform recording using volume plethysmography, followed by ultrasound duplex scan. The presence of peripheral arterial disease was recorded if ankle brachial index <0.9; pulse volume waveform was graded as 2, 3 or 4; or if haemodynamically significant stenosis >50% was evident with ultrasound duplex scan. Outcome measure was agreement between the measured ankle brachial index and interpretation of pulse volume waveform for peripheral arterial disease diagnosis, using ultrasound duplex scan as the reference standard.</p></sec><sec id="section3-2050312116659088"><title>Results:</title><p>Sensitivity of ankle brachial index was 79%, specificity 91% and overall accuracy 88%. Pulse volume waveform sensitivity was 97%, specificity 81% and overall accuracy 85%. The combined sensitivity of ankle brachial index and pulse volume waveform was 100%, specificity 76% and overall accuracy 85%.</p></sec><sec id="section4-2050312116659088"><title>Conclusion:</title><p>Combining these two diagnostic modalities within one device provided a highly accurate method of ruling out peripheral arterial disease, which could be utilised in primary care to safely reduce unnecessary secondary care referrals.</p></sec></abstract><kwd-group><kwd>Automated ankle brachial index</kwd><kwd>pulse volume</kwd><kwd>pulse volume waveform</kwd><kwd>ultrasound duplex scan</kwd><kwd>peripheral arterial disease</kwd><kwd>lower limb</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>cover-date</meta-name><meta-value>January-December 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Royaume-Uni</li></country></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Lewis, Jane Ea" sort="Lewis, Jane Ea" uniqKey="Lewis J" first="Jane Ea" last="Lewis">Jane Ea Lewis</name></noRegion><name sortKey="Davies, Jane H" sort="Davies, Jane H" uniqKey="Davies J" first="Jane H" last="Davies">Jane H. Davies</name><name sortKey="Williams, Paul" sort="Williams, Paul" uniqKey="Williams P" first="Paul" last="Williams">Paul Williams</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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