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A comparative study to assess the Ankle Brachial Index by palpatory and Doppler method

Nitta Das, Ambuj Roy, Ashok Kumar Jaryal, Gopichandran Lakshmanan, Manju Dhandapani


Background of the study: Peripheral arterial disease (PAD) is strongly associated with cardiovascular and cerebrovascular morbidity and mortality. Relatively few non-invasive diagnostic tests are available that can reveal the evidence of atherosclerosis before the development of symptoms. One such simple, cost effective diagnostic test is Ankle Brachial Index. Since, there is a need to validate palpatory method of Ankle Brachial Index (ABI) measurement, the study was conceived.

Aim of the study: To assess the diagnostic accuracy of palpatory method with gold standard doppler method in measuring ABI.

Materials and methods: This comparative study was conducted in Cardiac catheterization laboratory of Tertiary Care Center, North India, among 62 subjects who were selected purposively. ABI was measured using both palpatory and doppler method and were compared using Bland-Altman plot and diagnostic test evaluation method.

Results: Majority of subjects were males (95%). The most prevalent risk factor was hypertension (53%). Bland-Altman plot revealed that there was an agreement between palpatory and doppler ABI measurements. ABI measured using palpatory method had an excellent sensitivity of 100% and acceptable specificity of 89.66%. The positive predictive value was 40% and the negative predictive value was 100%.

Conclusion: Palpatory method for measuring ABI could be used to rule out PAD cases.

Key words: Ankle brachial index, palpatory method, doppler method

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