Catillon Floriane, Tuffier Stéphane, Guilcher Antoine, Tollenaere Quentin, Métairie Antoine, Miossec Annaïg, Mauger Chadi, Laneelle Damien, Mahé Guillaume
CHU Rennes, Médecine Vasculaire, Rennes, France.
Univ Rennes 1, Public Health Department, Rennes, France.
Ann Vasc Surg. 2020 May;65:183-189. doi: 10.1016/j.avsg.2019.10.092. Epub 2019 Nov 6.
Pressure measurement is a key component in the diagnosis of lower extremity peripheral artery disease (PAD) but is technically challenging and time-consuming for nonvascular specialists, thus hindering its wider implementation. The aim of this study was to assess the proficiency of students at obtaining satisfactory ankle or toe pressure readings for PAD diagnosis using 2 automated devices.
Medical students followed a training session after which they performed ankle and toe pressure measurements to calculate the ankle-brachial index (ABI) using the MESI ABPI MD® device, and the toe-brachial index (TBI) using the SYSTOE® device. Blinded vascular specialists took the same measurements. Use of the automated devices was considered satisfactory when a valid reading was measured in as few attempts as possible. A comparison was made of each student's proficiency at performing valid ankle and toe pressure measurements. The secondary objective was to compare the readings taken by the vascular specialists with those of the students.
Forty-three medical students were included. Mean number of attempts was 1.23 ± 0.48 with the MESI ABPI MD device and 1.44 ± 0.55 with the SYSTOE device (P = 0.04). There was no statistically significant difference between ABI readings taken by the students and those taken by the vascular specialists, 1.17 (0.90; 1.39) vs. 1.18 (0.86; 1.39) (P = 0.33), contrary to TBI readings 0.70 (0.22; 1.74) vs. 0.72 (0.23; 1.16) (P = 0.03). Measurement duration for the students and vascular specialists was 3.75 min ± 1.12 min and 2.26 min ± 0.82 min (P < 0.01) with the MESI ABPI MD device and 4.30 min ± 1.23 min and 3.33 min ± 1.49 min (P = 0.03) with the SYSTOE device. Correlation coefficients between the students and the vascular specialists were 0.56 and 0.34 with the MESI ABPI MD and SYSTOE devices (P < 0.05).
After a brief theoretical training session, the medical students were better at taking ankle pressure measurements than toe pressure measurements with an automated device for the purposes of PAD diagnosis. It would be of value to assess the advantages of these automated devices in primary care practice in future research.
压力测量是下肢外周动脉疾病（PAD）诊断的关键组成部分，但对于非血管专科医生来说，该技术具有挑战性且耗时，因此阻碍了其更广泛的应用。本研究的目的是评估学生使用两种自动化设备获取用于PAD诊断的满意踝部或趾部压力读数的熟练程度。
医学生参加培训课程后，使用MESI ABPI MD®设备进行踝部和趾部压力测量以计算踝肱指数（ABI），并使用SYSTOE®设备计算趾肱指数（TBI）。不知情的血管专科医生进行相同的测量。当在尽可能少的尝试中获得有效读数时，认为自动化设备的使用是令人满意的。比较了每个学生进行有效踝部和趾部压力测量的熟练程度。次要目标是比较血管专科医生和学生所获取的读数。
纳入43名医学生。使用MESI ABPI MD设备时，平均尝试次数为1.23±0.48次，使用SYSTOE设备时为1.44±0.55次（P = 0.04）。学生获取的ABI读数与血管专科医生获取的读数之间无统计学显著差异，分别为1.17（0.90；1.39）和1.18（0.86；1.39）（P = 0.33），但TBI读数存在差异，分别为0.70（0.22；1.74）和0.72（0.23；1.16）（P = 0.03）。使用MESI ABPI MD设备时，学生和血管专科医生的测量持续时间分别为3.75分钟±1.12分钟和2.26分钟±0.82分钟（P < 0.01），使用SYSTOE设备时分别为4.30分钟±1.23分钟和3.33分钟±1.49分钟（P = 0.03）。学生与血管专科医生之间使用MESI ABPI MD和SYSTOE设备的相关系数分别为0.56和0.34（P < 0.05）。
经过简短的理论培训课程后，医学生使用自动化设备进行踝部压力测量比趾部压力测量更擅长，用于PAD诊断。在未来研究中评估这些自动化设备在初级保健实践中的优势将具有重要意义。
