Diagnostic Accuracy Study of an Oscillometric Ankle-Brachial Index in Peripheral Arterial Disease: The Influence of Oscillometric Errors and Calcified Legs.
Diagnostic Accuracy Study of an Oscillometric Ankle-Brachial Index in Peripheral Arterial Disease: The Influence of Oscillometric Errors and Calcified Legs.
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DOI：
10.1371/journal.pone.0167408
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Notario-Pacheco B
中科院分区：
文献类型：
--
作者：
Herráiz-Adillo Á;Martínez-Vizcaíno V;Cavero-Redondo I;Álvarez-Bueno C;Garrido-Miguel M;Notario-Pacheco B
外周动脉疾病（PAD）是广泛动脉粥样硬化的指标。然而，大多数患有PAD的人，尽管心血管风险很高，但没有症状。这一事实，加上多普勒踝臂指数（ABI）的局限性，有助于PAD的诊断不足。本研究的目的是比较多普勒ABI和多普勒ABI对外周动脉疾病的诊断，并研究多普勒测量误差和钙化腿对PAD诊断的影响。我们使用OMRON-M3和多普勒测量仪测量了90名志愿者（n = 180条腿，年龄70 ± 14岁，43%糖尿病患者）的踝臂指数。对于一致性分析，我们使用了Bland和Altman方法，并估计了组内相关系数。受试者工作特征曲线用于检查两种方法的诊断性能。通过血压计和多普勒ABI测量的ABI平均值分别为1.06 ± 0.14和1.04 ± 0.16（p = 0.034），一致性限为± 0.20，组内相关系数= 0.769。示波器产生了23个“错误”的测量，也高估了测量低踝关节压力。使用多普勒作为金标准，用于诊断PAD的多普勒性能显示曲线下面积= 0.944（灵敏度：66.7%，特异性：96.8%）。此外，当考虑钙化的腿部和动脉测量的“错误”读数作为动脉病的等价物时，敏感性上升到78.2%，特异性保持在96%。最佳诊断临界点为0.96（敏感性：87%，特异性：91%，阳性似然比：9.66，阴性似然比：0.14）。尽管存在局限性，示波法踝臂指数可能是诊断外周动脉疾病的有用工具，特别是当考虑将钙化腿部和示波法“错误”读数视为外周动脉疾病等效物时。
Peripheral arterial disease (PAD) is an indicator of widespread atherosclerosis. However, most individuals with PAD, in spite of being at high cardiovascular risk, are asymptomatic. This fact, together with the limitations of the Doppler ankle-brachial index (ABI), contributes to PAD underdiagnose. The aim of this study was to compare oscillometric ABI and Doppler ABI to diagnose peripheral arterial disease, and also to examine the influence of oscillometric errors and calcified legs on the PAD diagnoses. We measured the ankle-brachial indexes of 90 volunteers (n = 180 legs, age 70 ± 14 years, 43% diabetics) using both oscillometer OMRON-M3 and Doppler. For concordance analyses we used the Bland and Altman method, and also estimated the intraclass correlation coefficient. Receiver Operating Characteristic Curves were used to examine the diagnostic performance of both methods. The ABI means were 1.06 ± 0.14 and 1.04 ± 0.16 (p = 0.034) measured by oscillometer and Doppler ABIs respectively, with limits of agreement of ± 0.20 and intraclass correlation coefficient = 0.769. Oscillometer yielded 23 “error” measurements, and also overestimated the measurements in low ankle pressures. Using Doppler as gold standard, oscillometer performance for diagnosis of PAD showed an Area Under Curve = 0.944 (sensitivity: 66.7%, specificity: 96.8%). Moreover, when considered calcified legs and oscillometric “error” readings as arteriopathy equivalents, sensitivity rose to 78.2%, maintaining specificity in 96%. The best oscillometer cut-off point was 0.96 (sensitivity: 87%, specificity: 91%, positive likelihood ratio: 9.66 and negative likelihood ratio: 0.14). Despite its limitations, oscillometric ABI could be a useful tool for the diagnosis of PAD, particularly when considering calcified legs and oscillometric “errors” readings as peripheral arterial disease equivalents.
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影响因子：
2.1
作者：
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通讯作者：
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影响因子：
3.2
作者：
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影响因子：
5.4
作者：
Kollias, Anastasios;Xilomenos, Apostolos;Stergiou, George S.
通讯作者：
Stergiou, George S.
影响因子：
5.3
作者：
Diehm, C;Schuster, A;Trampisch, HJ
通讯作者：
Trampisch, HJ
影响因子：
2.9
作者：
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通讯作者：
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