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Factors affecting the validity of the oscillometric Ankle Brachial Index to detect peripheral arterial disease

dc.contributor.authorHerráiz-Adillo Á.
dc.contributor.authorCavero-Redondo I.
dc.contributor.authorÁlvarez-Bueno C.
dc.contributor.authorMartartínez-Vizcaíno V.
dc.contributor.authorPozuelo-Carrascosa D.P.
dc.contributor.authorNotarnotario-Pacheco B.
dc.date.accessioned2020-09-02T22:20:28Z
dc.date.available2020-09-02T22:20:28Z
dc.date.issued2017
dc.identifier10.23736/S0392-9590.17.03860-3
dc.identifier.citation36, 6, 536-544
dc.identifier.issn03929590
dc.identifier.urihttps://hdl.handle.net/20.500.12728/4887
dc.descriptionBACKGROUND: The use of oscillometric Ankle Brachial Index (ABI) to diagnose peripheral arterial disease (PAD) has raised concern, especially due to a lack of agreement and sensitivity. This study aimed to evaluate those factors affecting the validity of oscillometric ABI in comparison to Doppler ABI to detect PAD. METHODS: Through univariate and multivariate linear regression, we studied those factors affecting the differences between oscillometric and Doppler ABI; through univariate and multivariate logistic regression we analyzed the false negative rate of oscillometric ABI to detect PAD. RESULTS: We analyzed 197 consecutive subjects (394 legs) from two settings: Primary Care and Vascular Service. The means of oscillometric ABI and Doppler ABI were 1.094 (95% CI: 0.843-1.345) and 1.073 (95% CI: 0.769-1.374) (P<0.001), respectively. In men, covariates explaining the differences between oscillometric and Doppler ABI were Doppler ankle blood pressure (β=-0.610, P<0.001), ankle circumference (β=0.176, P=0.004) and oscillometric brachial blood pressure (β=0.136, P=0.037); in women, those were weight (β=0.351, P<0.001) and Doppler ankle blood pressure (β=-0.318, P<0.001). Sensitivity and specificity of oscillometric ABI to detect PAD were 80.6% and 97.4%, respectively, and covariates explaining the rate of false negatives in PAD population were setting (Exp(β)=17.21, P=0.009) and tobacco (packs/year) (Exp(β)=1.049, P=0.002). CONCLUSIONS: Although some factors influencing the lack of agreement between oscillometric and Doppler ABI were identified, the correction of oscillometric ABI seems impractical, since Doppler is needed, the bias is not always uniformly distributed and its clinical relevance is small. According to sensitivity, borderline oscillometric ABI in Primary Care settings and smokers suggest PAD. © 2017 EDIZIONI MINER VA MEDICA.
dc.language.isoen
dc.publisherEdizioni Minerva Medica
dc.subjectAnkle Brachial Index
dc.subjectOscillometry
dc.subjectPeripheral arterial disease
dc.subjectSensitivity and specificity
dc.subjectaged
dc.subjectankle brachial index
dc.subjectArticle
dc.subjectbody weight
dc.subjectcalcification
dc.subjectcohort analysis
dc.subjectcomparative study
dc.subjectdiagnostic accuracy
dc.subjectdiagnostic test accuracy study
dc.subjectDoppler flowmetry
dc.subjectfalse negative result
dc.subjectfemale
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectobservational study
dc.subjectoscillometry
dc.subjectperipheral occlusive artery disease
dc.subjectprospective study
dc.subjectreceiver operating characteristic
dc.subjectsensitivity and specificity
dc.subjecttobacco consumption
dc.subjectvalidity
dc.subjectankle brachial index
dc.subjectbrachial artery
dc.subjectDoppler ultrasonography
dc.subjectmiddle aged
dc.subjectmultivariate analysis
dc.subjectoscillometry
dc.subjectpathophysiology
dc.subjectperipheral occlusive artery disease
dc.subjectprocedures
dc.subjectstatistical model
dc.subjectvalidation study
dc.subjectvery elderly
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectAnkle Brachial Index
dc.subjectBrachial Artery
dc.subjectFemale
dc.subjectHumans
dc.subjectLinear Models
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMultivariate Analysis
dc.subjectOscillometry
dc.subjectPeripheral Arterial Disease
dc.subjectProspective Studies
dc.subjectSensitivity and Specificity
dc.subjectUltrasonography, Doppler
dc.titleFactors affecting the validity of the oscillometric Ankle Brachial Index to detect peripheral arterial disease
dc.typeArticle


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