Yvonne Midolo Azzopardi1, Alfred Gatt2, Nachiappan Chockalingam3, Cynthia Formosa4. 1. Faculty of Health Sciences, University of Malta, Malta. Electronic address: yvonne.a.azzorpadi@gov.mt. 2. Faculty of Health Sciences, University of Malta, Malta; School of Life Sciences and Education, Staffordshire University, United Kingdom. Electronic address: Alfred.gatt@um.edu.mt. 3. Faculty of Health Sciences, University of Malta, Malta; School of Life Sciences and Education, Staffordshire University, United Kingdom. Electronic address: N.Chockalingam@staffs.ac.uk. 4. Faculty of Health Sciences, University of Malta, Malta; School of Life Sciences and Education, Staffordshire University, United Kingdom. Electronic address: Cynthia.formosa@um.edu.mt.
Abstract
AIM: The aim of this study was to compare different screening modalities in the detection of PAD in a primary care setting. METHODS: Fifty participants living with Type 2 diabetes were recruited. Pulse palpation, waveform analysis, ankle brachial pressure index, absolute toe pressure, toe brachial pressure index and transcutaneous oxygen pressure were compared in the detection of peripheral arterial disease. One hundred limbs were included for analysis. RESULTS: This study showed different results in peripheral arterial disease screening tests in the same group of participants. The highest percentage of participants who had PAD was for the Doppler Waveform (93.0%). This was followed by TBPI (72.0%), ABPI (57.0%), ATP (35.0%), TCPO (30.0%) and pulse palpation (23.0%). The difference between these percentages is significant (p<0.0005). The magnitude of the effect size is medium/moderate (Cramer's V=0.498). CONCLUSION: This study demonstrates that inconsistencies exist between the agreement of the 6 different modalities used to detect PAD. These findings should create an awareness amongst clinicians when interpreting results of these tests. The authors advocate for urgent, more robust studies utilizing a gold standard modality for the diagnosis of PAD in order to provide evidence regarding which screening modalities would yield the most valid results.
AIM: The aim of this study was to compare different screening modalities in the detection of PAD in a primary care setting. METHODS: Fifty participants living with Type 2 diabetes were recruited. Pulse palpation, waveform analysis, ankle brachial pressure index, absolute toe pressure, toe brachial pressure index and transcutaneous oxygen pressure were compared in the detection of peripheral arterial disease. One hundred limbs were included for analysis. RESULTS: This study showed different results in peripheral arterial disease screening tests in the same group of participants. The highest percentage of participants who had PAD was for the Doppler Waveform (93.0%). This was followed by TBPI (72.0%), ABPI (57.0%), ATP (35.0%), TCPO (30.0%) and pulse palpation (23.0%). The difference between these percentages is significant (p<0.0005). The magnitude of the effect size is medium/moderate (Cramer's V=0.498). CONCLUSION: This study demonstrates that inconsistencies exist between the agreement of the 6 different modalities used to detect PAD. These findings should create an awareness amongst clinicians when interpreting results of these tests. The authors advocate for urgent, more robust studies utilizing a gold standard modality for the diagnosis of PAD in order to provide evidence regarding which screening modalities would yield the most valid results.
Authors: Annaïg Miossec; Quentin Tollenaere; Damien Lanéelle; Antoine Guilcher; Antoine Métairie; Estelle Le Pabic; Awenig Carel; Alexis Le Faucheur; Guillaume Mahé Journal: Front Cardiovasc Med Date: 2021-04-20