Department of Internal Medicine, Division of General Internal Medicine, Hospital Marina Baixa, Villajoyosa, Alicante, Spain.
Diabetes Res Clin Pract. 2011 Jun;92(3):329-36. doi: 10.1016/j.diabres.2011.02.015. Epub 2011 Mar 11.
Upper arm automated blood pressure devices are widely available and could be used to estimate the ankle-brachial index.
We conducted a trial to determine the equivalence of ankle-brachial index estimated by an upper arm blood pressure measuring device as index method compared to the handheld Doppler method as the reference standard. A total of 110 patients with diabetes mellitus were sequentially examined by two methods.
The prevalence of peripheral arterial disease was 32%. The index method obtained valid measurements in 104 (95%) patients. Ankle-brachial index was lower with the index method compared to the reference standard (mean difference: -0.05; 95% confidence interval [CI]: -0.50 to 0.39). This confidence interval was above the boundaries clinically established as equivalence margins in our study. The kappa agreement between two methods was 0.45. The performance of the index method was: sensitivity: 67%; specificity: 87%; positive likelihood ratio: 5.25; negative likelihood ratio: 0.18; positive predictive value: 71%; negative predictive value: 85%; and the area under the receiving operating characteristic curve: 0.87 (95% CI: 0.78-0.93).
Upper arm automated blood pressure measuring devices cannot replace the handheld Doppler method to estimate the ankle-brachial index in patients with diabetes mellitus.
上臂自动血压设备应用广泛，可用于估算踝臂指数。
我们开展了一项试验，旨在确定上臂血压测量设备估算的踝臂指数与手持式多普勒方法作为参考标准相比，是否具有等效性。共有 110 例糖尿病患者按顺序接受了两种方法的检查。
外周动脉疾病的患病率为 32%。指数法在 104 例（95%）患者中获得了有效测量值。与参考标准相比，指数法测量的踝臂指数较低（平均差值：-0.05；95%置信区间[CI]：-0.50 至 0.39）。该置信区间超出了我们研究中作为等效性边界的临床设定值。两种方法之间的kappa 一致性为 0.45。指数法的性能为：敏感性：67%；特异性：87%；阳性似然比：5.25；阴性似然比：0.18；阳性预测值：71%；阴性预测值：85%；以及接收者操作特征曲线下面积：0.87（95%CI：0.78-0.93）。
上臂自动血压测量设备不能替代手持式多普勒方法来估算糖尿病患者的踝臂指数。
