Concordance between 3 methods of measurement the ankle-brachial index to diagnose peripheral artery disease

Background and objectives: To determine the concordance of the ankle-brachial index (ABI) determiried by automatic measurements (sphygmomanometer Omron and the triple cuff device) using doppler as the gold-standard, computing as well as sensitivity and specificity. Patients and methods: ARTPER population cohort subjects, classified as peripheral arterial disease (PAD) if ABI < 0.9, calcified if ABI >= 1.4 and healthy otherwise. To asses concordance we used kappa index using the 3 categories and the intraclass correlation coefficient (ICC) for ABI continuous values. Results: Eighty-eight participants, 52% women, 57-87 years. It was possible to calculate the ABI using doppler for 100%, 97% using Omron and 95% using triple. ABI means (standard deviation) were: doppler 1.089 (0.236), Omron 1.082 (0.110), triple 1.146 (0.134), with poor agreement (ICC doppler/Omron = 0.27, doppler/ triple = 0.13, and triple/Omron = 0.39). Categorizing ABI as PAD-healthy-calcified 13.6% (doppler), 6.8% (Omron) and 3.4% (triple) were PAD and 9.1% (doppler), 1.1% (Omron) and 9.1% (triple) were calcified. Kappa indexes were weak (doppler/Omron = 0.22, doppler/triple = 0.01, triple/Omron = 0.17). Both triple and Omron were highly specific (97%) but had very low sensitivity (8 and 33%, respectively) compared to doppler. Conclusions: Concordance of ABI automatic measurements as Omron,and triple with doppler was poor, and they do not seem suitable for screening for PAD in primary care consultations. (C) 2013 Elsevier Espana, S.L.U. All rights reserved.