title: Comparison of the severity of lower extremity arterial disease in smokers and patients with diabetes using a novel duplex Doppler scoring system.
abstract: OBJECTIVE
  The aim of this study was to validate the diagnostic feasibility of a novel scoring system of peripheral arterial disease (PAD) in smokers and patients with diabetes depending on duplex Doppler sonographic features.
  
  
  METHODS
  Patients presenting with the symptomatology of PAD were divided into three groups: diabetes only, smoking only, and smokers with diabetes. The patients were clinically examined, a clinical severity score was obtained, and the subjects were categorized into the three extrapolated categories of mild, moderate, and severe. All 106 subjects also underwent a thorough duplex Doppler examination, and various aspects of PAD were assessed and tabulated. These components were used to create a novel duplex Doppler scoring system. Depending on the scores obtained, each individual was categorized as having mild, moderate, or severe illness. The Cohen kappa value was used to assess interobserver agreement between the two scoring systems.
  
  
  RESULTS
  Interobserver agreement between the traditional Rutherford clinical scoring system and the newly invented duplex Doppler scoring system showed a kappa value of 0.83, indicating significant agreement between the two scoring systems (P<0.001).
  
  
  CONCLUSIONS
  Duplex Doppler imaging is an effective screening investigation for lower extremity arterial disease, as it not only helps in its diagnosis, but also in the staging and grading of the disease, providing information that can be utilized for future management and treatment planning.
authors.affiliation: Department of Radiodiagnosis and Imaging, KVG Medical College and Hospital, Sullia, India.
authors.forename: Rudresh
authors.identifier: 0000-0003-0387-9359
authors.initials: R
authors.lastname: Hiremath
authors.affiliation: Department of Radiodiagnosis and Imaging, KVG Medical College and Hospital, Sullia, India.
authors.forename: Goutham
authors.identifier: 0000-0001-8390-5056
authors.initials: G
authors.lastname: Gowda
authors.affiliation: Department of Radiodiagnosis and Imaging, KVG Medical College and Hospital, Sullia, India.
authors.forename: Jebin
authors.identifier: 0000-0002-8541-8929
authors.initials: J
authors.lastname: Ibrahim
authors.affiliation: Department of Radiodiagnosis and Imaging, KVG Medical College and Hospital, Sullia, India.
authors.forename: Harish T
authors.identifier: 0000-0001-9873-8692
authors.initials: HT
authors.lastname: Reddy
authors.affiliation: Department of Radiodiagnosis and Imaging, KVG Medical College and Hospital, Sullia, India.
authors.forename: Haritha
authors.identifier: 0000-0002-0916-201X
authors.initials: H
authors.lastname: Chodiboina
authors.affiliation: Department of Radiodiagnosis and Imaging, KVG Medical College and Hospital, Sullia, India.
authors.forename: Rushit
authors.identifier: 0000-0001-7953-8628
authors.initials: R
authors.lastname: Shah
keywords: Duplex Doppler scoring system; Peripheral arterial disease; Ultrasonography, Doppler, duplex