title: Number of distal limb and brachial pressure measurements required when diagnosing peripheral arterial disease by laser Doppler flowmetry.
abstract: We examine the reliability of single and repeated blood pressure measurements at ankle, toe, and arm levels for the diagnosis of peripheral arterial disease (PAD) by laser Doppler flowmetry. Segmental pressures were measured in 200 patients with known or suspected PAD. Segmental indices were calculated using (1) one measurement [M-1], two measurements [M-2], or by a predefined reproducibility criterion (RC) as well as (2) by using one brachial blood-pressure (BBP-one) or correspondent to each segmental pressure (BBP-all) as reference. The agreement in diagnosis of PAD by Cohen's Kappa was κ = 0.930 when comparing RC to M-1, and κ = 0.977 when comparing RC to M-2. The same comparison showed excellent relative reliability for segmental indices (all intra-class correlation coefficients (ICC) ≥ 0.980). Diagnostic classification agreement for BBP-all versus BBP-one were κ = 0.831 for RC, κ = 0.804 for M-1, and κ = 0.847 for M-2. The relative reliability analysis showed excellent correlation in segmental indices (all ICC ≥ 0.957). The study shows minimal difference in segmental indices and diagnostic classification when comparing calculations based on the listed strategies. However, the study indicated that it is important to measure BBPs correspondent to each segmental pressure.
authors.affiliation: Department of Clinical Physiology, Viborg Regional Hospital, DK-8800 Viborg, Denmark. Department of Health Science and Technology, Aalborg University, DK-9220 Aalborg, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Høyer
authors.forename: J A
authors.initials: JA
authors.lastname: Biurrun Manresa
authors.forename: L J
authors.initials: LJ
authors.lastname: Petersen
mesh_terms: D000842:Ankle; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology*; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000379:methods*; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000503:physiopathology*; D015203:Reproducibility of Results; D014034:Toes