Tehan PE, Chuter VH, et al.
Journal of foot and ankle research. Date of publication 2016 Dec 7;volume 9():48.
1. J Foot Ankle Res. 2016 Dec 7;9:48. doi: 10.1186/s13047-016-0181-2. eCollection
2016.
A targeted screening method for non-invasive vascular assessment of the lower
limb.
Tehan PE(1), Chuter VH(1).
Author information:
(1)School of Health Sciences, Faculty of Health, University of Newcastle,
Ourimbah, NSW 2258 Australia.
BACKGROUND: Podiatrists routinely perform non-invasive lower limb vascular
assessment, however frequently cite time as a major barrier in performing
regular assessment. The aim of this study was to develop an evidence-based
vascular assessment method to guide podiatrists' decision-making processes to
aid in timely vascular assessment in at risk populations.
METHOD: The sample underwent brachial pressure measurement, ankle pressures, toe
pressure and Doppler waveform with colour duplex ultrasound (CFDU) used as the
reference standard. Both the targeted screening method and the American Heart
Association (AHA) guideline for vascular screening were then applied to the data
set and sensitivity and specificity of each method was calculated.
RESULTS: One hundred nineteen participants were included. Sensitivity of the
targeted screening method (62%, 95% CI 47.17-75.35) was higher than the AHA
method (49%, 95% CI 34.75-63.40), however, specificity of the AHA method (94%,
95% CI 85.62-98.37) was higher than the targeted screening method (85%, 95% CI
74.26-92.60). Diagnostic accuracy was similar with the AHA method yielding 74%
diagnostic accuracy and the targeted screening method 73%.
CONCLUSION: The targeted screening method and the broad international guideline
demonstrated similar accuracy, however clinicians may save time using the
targeted screening method. This study highlights the difficulties in obtaining
accuracy in lower limb vascular assessment in general.
DOI: 10.1186/s13047-016-0181-2
PMCID: PMC5142395
PMID: 27980685 [Indexed for MEDLINE]
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