title: The influence of experience on the reproducibility of the ankle-brachial systolic pressure ratio in peripheral arterial occlusive disease.
abstract: OBJECTIVE
  to estimate the intra-observer variability of the measurement of the ankle-brachial systolic pressure index (ABPI) and to compare the reproducibility of the measurements by experienced vascular laboratory assistants and by less-experienced general practice personnel.
  
  
  METHODS
  repeated measurement of ABPI by general practitioners (GPs), GP-assistants and vascular laboratory assistants using a pocket Doppler device and a random-zero sphygmomanometer.
  
  
  METHODS
  ABPI was measured in six patients with various degrees of PAOD by two experienced observers (vascular laboratory assistants) and by 24 less-experienced observers (18 practice assistants, six GPs).
  
  
  RESULTS
  the total number of measurements was 354. The overall intra-observer variability estimate was 11.8% ABPI. The intra-observer variability was 7.3% in the experienced observers and 12.0% in the less-experienced observers. The difference of variability between experienced and less-experienced observers was significant.
  
  
  CONCLUSIONS
  the ABPI is suitable in follow-up studies where repeated measurements are needed. Differences between measurements can be minimised by performing repeated measurements or by using more experienced observers.
authors.affiliation: Department of General Practice, Maastricht University, Maastricht, The Netherlands.
authors.forename: V
authors.initials: V
authors.lastname: Kaiser
authors.forename: A D
authors.initials: AD
authors.lastname: Kester
authors.forename: H E
authors.initials: HE
authors.lastname: Stoffers
authors.forename: P J
authors.initials: PJ
authors.lastname: Kitslaar
authors.forename: J A
authors.initials: JA
authors.lastname: Knottnerus
mesh_terms: D000368:Aged; D000842:Ankle / Q000098:blood supply*; D001157:Arterial Occlusive Diseases / Q000503:physiopathology*; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology*; D002983:Clinical Competence; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D019722:Sphygmomanometers; D013223:Statistics as Topic