1. 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.
- Author
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Tehan PE, Bray A, and Chuter VH
- Subjects
- Aged, Aged, 80 and over, Ankle Brachial Index, Case-Control Studies, Cohort Studies, Cross-Sectional Studies, Diabetic Angiopathies diagnosis, Diabetic Angiopathies epidemiology, Early Diagnosis, Female, Foot blood supply, Humans, Male, Middle Aged, New South Wales epidemiology, Peripheral Vascular Diseases diagnosis, Peripheral Vascular Diseases diagnostic imaging, Peripheral Vascular Diseases epidemiology, Private Practice, Prospective Studies, Risk, Sensitivity and Specificity, Ultrasonography, Doppler, Color, Diabetic Angiopathies diagnostic imaging, Foot diagnostic imaging, Regional Blood Flow
- Abstract
Background & Aims: Non-invasive lower limb vascular assessment in people at risk of peripheral arterial disease (PAD) including those with diabetes is crucial. There is evidence that standard assessment techniques such as the ankle-brachial index (ABI) may be less effective in people with diabetes. However there is limited evidence for other frequently used tests including continuous wave Doppler (CWD), and the toe-brachial index (TBI). The aim of this study was to determine the sensitivity and specificity of, ABI, CWD and TBI in a population with, and without diabetes., Methods: Participants with and without diabetes who met current guidelines for vascular screening were recruited, and CWD waveforms, an ABI and a TBI were obtained from the right lower limb. Diagnostic accuracy was determined using colour duplex ultrasound (CFDU). Receiver operating characteristic curves were calculated., Results: 117 participants were recruited, seventy-two with diabetes and forty-five without diabetes. CWD had the highest sensitivity in people with diabetes (74%) and without (84%). CWD also had the highest specificity in people with diabetes (74%) and without (84%) compared to both TBI and ABI. In participants with diabetes, the ABI was a poor test, area under the curve: 0.58 (p=0.27)., Conclusions: CWD waveform is more likely to detect significant PAD compared to ABI and TBI in people with and without diabetes., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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