title: Sensitivity and Specificity of the Toe-Brachial Index for Detecting Peripheral Arterial Disease: Initial Findings.
abstract: OBJECTIVE
  The toe-brachial index (TBI) is an alternative to the ankle-brachial index (ABI) in screening for peripheral arterial disease (PAD); however, there is limited evidence comparing their diagnostic accuracy. This study compared the diagnostic accuracy of the ABI and TBI in a population at risk of PAD.
  
  
  METHODS
  The sensitivity and specificity of the ABI and TBI were determined by color duplex sonography. Receiver operating characteristic (ROC) analysis was performed.
  
  
  RESULTS
  A total of 119 participants were recruited (75 male and 44 female). The sensitivity for PAD was highest for the TBI (71%; ABI, 45%), and the specificity was highest for the ABI (93%; TBI, 78%). Receiver operating characteristic analysis indicated that the TBI (ROC area, 0.77; P = .0001) had greater clinical efficacy for diagnosis of PAD than the ABI (ROC area, 0.65; P = .005).
  
  
  CONCLUSIONS
  In specific populations, the TBI may have greater clinical efficacy than the ABI for diagnosis of PAD.
authors: School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah, New South Wales, Australia (P.T., V.H.C.); and Vascular Health Care, Gateshead, New South Wales, Australia (A.B., R.K., R.R., A.C.). peta.craike@newcastle.edu.au.
authors: Peta
authors: P
authors: Tehan
authors: School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah, New South Wales, Australia (P.T., V.H.C.); and Vascular Health Care, Gateshead, New South Wales, Australia (A.B., R.K., R.R., A.C.).
authors: Alan
authors: A
authors: Bray
authors: School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah, New South Wales, Australia (P.T., V.H.C.); and Vascular Health Care, Gateshead, New South Wales, Australia (A.B., R.K., R.R., A.C.).
authors: Ruth
authors: R
authors: Keech
authors: School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah, New South Wales, Australia (P.T., V.H.C.); and Vascular Health Care, Gateshead, New South Wales, Australia (A.B., R.K., R.R., A.C.).
authors: Richard
authors: R
authors: Rounsley
authors: School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah, New South Wales, Australia (P.T., V.H.C.); and Vascular Health Care, Gateshead, New South Wales, Australia (A.B., R.K., R.R., A.C.).
authors: Angela
authors: A
authors: Carruthers
authors: School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah, New South Wales, Australia (P.T., V.H.C.); and Vascular Health Care, Gateshead, New South Wales, Australia (A.B., R.K., R.R., A.C.).
authors: Vivienne Helaine
authors: VH
authors: Chuter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D055109:Ankle Brachial Index / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D058729:Peripheral Arterial Disease / Q000175:diagnosis*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
keywords: ankle-brachial index; peripheral arterial disease; sensitivity; specificity; toe-brachial index; vascular ultrasound