The influence of experience on the reproducibility of the ankle-brachial systolic pressure ratio in peripheral arterial occlusive disease.
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.
Kaiser
V
V
Department of General Practice, Maastricht University, Maastricht, The Netherlands.
Kester
A D
AD
Stoffers
H E
HE
Kitslaar
P J
PJ
Knottnerus
J A
JA
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