Kashetsky N, Sachdeva M, Lu JD, Mufti A, Kim P, Bagit A, Sibbald RG, et al.
Advances in skin & wound care. Date of publication 2022 Apr 1;volume 35(4):195-201.
1. Adv Skin Wound Care. 2022 Apr 1;35(4):195-201. doi:
10.1097/01.ASW.0000822628.82131.1d.
Diagnostic Accuracy of Ankle-Brachial Pressure Index Compared with Doppler
Arterial Waveforms for Detecting Peripheral Arterial Disease: A Systematic
Review.
Kashetsky N, Sachdeva M, Lu JD, Mufti A, Kim P, Bagit A, Sibbald RG.
GENERAL PURPOSE: 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).
TARGET AUDIENCE: This continuing education activity is intended for physicians,
physician assistants, nurse practitioners, and nurses with an interest in skin
and wound care.
LEARNING OBJECTIVES/OUTCOMES: 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.
Plain Language Summary: 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.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
DOI: 10.1097/01.ASW.0000822628.82131.1d
PMID: 35311767 [Indexed for MEDLINE]
