Automated oscillometric determination of the ankle-brachial index: a systematic review and meta-analysis
Hypertension Research, 07/18/2012
Evidence Based Medicine
Verberk WJ et al. – These data suggest that an automated ankle–brachial index (ABI) measurement obtained by oscillometric blood pressure monitors is a reliable and practical alternative to the conventional Doppler measurement for the detection of peripheral artery disease (PAD). To increase the sensitivity of the PAD diagnosis based on an oscillometric ABI, a higher threshold of 1.0 might be preferable.Methods
- This paper presents a systematic review (Medline/PubMed, Embase and Cochrane) and meta–analysis of studies assessing the usefulness of automated oscillometric devices for ABI estimation and PAD detection compared with the conventional Doppler method.
- A total of 25 studies including 4186 subjects were analyzed.
- A random–effects model analysis showed that the average oscillometric ABI was similar to the Doppler ABI (mean difference±s.e. 0.020±0.018, P=0.3) but that the absolute differences were significant (0.048±0.009, P<0.01).
- The pooled correlation coefficient (r) between the oscillometric and Doppler ABI was 0.71±0.05.
- Simultaneous arm–leg measurements resulted in a smaller difference between the average oscillometric ABI value and the average Doppler ABI value than did sequential measurements (–0.012±0.022 vs. 0.040±0.026, respectively, P<0.01).
- The average sensitivity and specificity of the oscillometric ABI estimation in PAD diagnosis was 69±6% and 96±1%, respectively (with Doppler ABI taken as the reference).