title: The clinical applicability of an automated plethysmographic determination of the ankle-brachial index after vascular surgery.
abstract: An automated ankle-brachial index device could lead to potential time savings and more accuracy in ankle-brachial index-determination after vascular surgery. This prospective cross-sectional study compared postprocedural ankle-brachial indices measured by a manual method with ankle-brachial indices of an automated plethysmographic method. Forty-two patients were included. No significant difference in time performing a measurement was observed (1.1 min, 95% CI: -0.2 to +2.4; P = 0.095). Mean ankle-brachial index with the automated method was 0.105 higher (95% CI: 0.017 to 0.193; P = 0.020) than with the manual method, with limits of agreement of -0.376 and +0.587. Total variance amounted to 0.0759 and the correlation between both methods was 0.60. Reliability expressed as maximum absolute difference (95% level) between duplicate ankle-brachial index-measurements under identical conditions was 0.350 (manual) and 0.152 (automated), although not significant (p = 0.053). Finally, the automated method had 34% points higher failure rate than the manual method. In conclusion based on this study, the automated ankle-brachial index-method seems not to be clinically applicable for measuring ankle-brachial index postoperatively in patients with vascular disease.
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands jvanderslegt@amphia.nl.
authors.forename: Jasper
authors.initials: J
authors.lastname: van der Slegt
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Nathalie Pa
authors.initials: NP
authors.lastname: Verbogt
authors.affiliation: Department of Amphia Academy, Amphia Hospital, Breda, The Netherlands.
authors.forename: Paul Gh
authors.initials: PG
authors.lastname: Mulder
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Stijn L
authors.initials: SL
authors.lastname: Steunenberg
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Bastiaan E
authors.initials: BE
authors.lastname: Steunenberg
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Lijckle
authors.initials: L
authors.lastname: van der Laan
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index / Q000295:instrumentation; D001331:Automation; D003430:Cross-Sectional Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010991:Plethysmography / Q000295:instrumentation; D011182:Postoperative Care / Q000295:instrumentation / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D014656:Vascular Surgical Procedures
keywords: Ankle-brachial index; automated device; diagnostics; outcome; vascular surgery