Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Vascular Surgery Unit, University Hospitals of Leicester NHS Trust, Leicester, UK.
Eur J Vasc Endovasc Surg. 2022 Dec;64(6):693-702. doi: 10.1016/j.ejvs.2022.08.008. Epub 2022 Aug 13.
To provide an overview of systems available for peripheral arterial disease (PAD) screening, together with respective accuracies and a clinical evaluation to identify a system suitable for use in a community screening programme.
A systematic review of the diagnostic accuracy of six ankle brachial pressure index (ABPI) and toe brachial pressure index (TBPI) devices deemed to be portable, which were Conformité Européenne (CE) marked, and were automated or semi-automated was carried out compared with gold standard handheld Doppler and duplex ultrasound. The devices were MESI-ABPI-MD, Huntleigh Dopplex Ability, Huntleigh ABPI and TBPI systems, Systoe TBPI system, and BlueDop. Seven databases (MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Register of Controlled Trials (CENTRAL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) were searched, and 11 studies were identified as eligible for review. This was followed by hands on clinical evaluation by abdominal aortic aneurysm (AAA) screening staff (n = 39). During this, devices were demonstrated to staff which they then tested on volunteers and gave feedback using pre-designed questionnaires on their suitability for use in a screening programme. Finally, accuracy data and staff preferences were combined during a consensus conference that was held between study and screening staff to determine the most appropriate device to use in a community screening programme.
Generally, the evaluated systems have a moderate level of sensitivity and a high level of specificity: Dopplex ability sensitivity 20% - 70%, specificity 86% - 96%; MESI sensitivity 57% - 74%, specificity 85% - 99%; BlueDop sensitivity 95%, specificity 89%; and Systoe sensitivity 71%, specificity 77%. Clinical evaluation by screening staff identified a preference for the MESI system. The consensus conference concluded that the MESI device was a good candidate for use in a community PAD screening programme.
The MESI system is a good candidate to consider for community PAD screening.
提供外周动脉疾病（PAD）筛查系统的概述，包括各自的准确性和临床评估，以确定适合社区筛查计划使用的系统。
对被认为是便携式的、符合欧洲标准（CE）的、自动化或半自动的六个体踝臂血压指数（ABPI）和趾臂血压指数（TBPI）设备的诊断准确性进行了系统评价，这些设备与金标准手持式多普勒和双功能超声进行了比较。这些设备包括 MESI-ABPI-MD、Huntleigh Dopplex Ability、Huntleigh ABPI 和 TBPI 系统、Systoe TBPI 系统和 BlueDop。共检索了 7 个数据库（MEDLINE、EMBASE、Scopus、Web of Science、Cochrane 系统评价数据库、Cochrane 对照试验登记册（CENTRAL）和 Cumulative Index to Nursing and Allied Health Literature（CINAHL）），并确定了 11 项符合审查条件的研究。随后，由腹主动脉瘤（AAA）筛查人员进行了实际的临床评估（n=39）。在此过程中，向工作人员展示了设备，然后让他们在志愿者身上进行测试，并使用预先设计的问卷就设备是否适合筛查计划提供反馈。最后，在研究人员和筛查人员之间举行了一次共识会议，将准确性数据和工作人员的偏好结合起来，以确定最适合社区筛查计划使用的设备。
评估的系统通常具有中等水平的敏感性和高水平的特异性：Dopplex Ability 的敏感性为 20%至 70%，特异性为 86%至 96%；MESI 的敏感性为 57%至 74%，特异性为 85%至 99%；BlueDop 的敏感性为 95%，特异性为 89%；Systoe 的敏感性为 71%，特异性为 77%。筛查人员的临床评估确定了对 MESI 系统的偏好。共识会议得出结论，MESI 设备是社区 PAD 筛查计划的良好候选者。
MESI 系统是社区 PAD 筛查的一个较好的候选者。
