Journal of Clinical Epidemiology
Volume 49, Issue 12 , Pages 1401-1405 , December 1996

The diagnostic value of the measurement of the ankle-brachial systolic pressure index in primary health care

  • Henri E.J.H. Stoffers

      Affiliations

    • Corresponding Author InformationAddress for correspondence: Dr. Henri E.J. H. Stoffers, Department of General Practice, University of Limburg, P.O. Box 616, NL-6200 MD Maastricht, The Netherlands.
    • Department of General Practice, University of Limburg, NL-6200 MD Maastricht, The Netherlands
    • ,
  • Arnold D.M. Kester

      Affiliations

    • Department of Methodology and Statistics, University of Limburg, NL-6200 MD Maastricht, The Netherlands
    • ,
  • Victor Kaiser

      Affiliations

    • Department of General Practice, University of Limburg, NL-6200 MD Maastricht, The Netherlands
    • ,
  • Paula E.L.M. Rinkens

      Affiliations

    • Department of General Practice, University of Limburg, NL-6200 MD Maastricht, The Netherlands
    • ,
  • Peter J.E.H.M. Kitslaar

      Affiliations

    • Department of Surgery, University of Limburg, NL-6200 MD Maastricht, The Netherlands
    • ,
  • J.André Knottnerus

      Affiliations

    • Department of General Practice, University of Limburg, NL-6200 MD Maastricht, The Netherlands

,Accepted 25 June 1996.

References 

  1. Wilt TJ. Current strategies in the diagnosis and management of lower extremity peripheral vascular disease. J Gen Intern Med. 1992;7:87–101
  2. Buth J. Het Vasculaire Laboratorium ([The vascular laboratory] (English summary)), In: 2nd Edn.. PhD Thesis. Amsterdam: Universiteit van Amsterdam; 1978;
  3. Kitslaar PJEHM. Doppler-UItrasoundtests in the Diagnosis of Chronic Aorta-Iliac Obstructions. In: 2nd Edn.. PhD Thesis. Maastricht: Rijksuniversiteit Limburg; 1982;
  4. In:  Bernstein EF editors. Noninvasive Diagnostic Techniques in Peripheral Vascular Disease. 2nd Edn.. St. Louis: Mosby; 1982;
  5. Strandness DE. Duplex scanning for diagnosis of peripheral arterial disease. Herz. 1988;13:372–377
  6. Cossman DV, Ellison JE, Wagner WH, Carroll RM, Treiman RL, Foran RF, et al.  Comparison of contrast arteriography to arterial mapping with color-flow duplex imaging in the lower extremities. J Vasc Surg. 1988;10:522–529
  7. Criqui MH, Fronek A, Klauber MR, Barrett Connor E, Gabriel S. The sensitivity, specificity and predictive value of traditional clinical evaluation of peripheral arterial disease: Results from non-invasive testing in a defined population. Circulation. 1985;71:516–522
  8. Hiatt WR, Marshall JA, Baxter J, et al.  Diagnostic methods for peripheral arterial disease in the San Luis Valley diabetes study. J Clin Epidemiol. 1990;43:597–606
  9. Stoffers HEJH. Peripheral arterial occlusive disease in general practice. A literature review. In: Peripheral Arterial Occlusive Disease: Prevalence and Diagnostic Management in General Practice. 2nd Edn.. PhD Thesis. Maastricht: Universitaire Pers Maastricht; 1995;p. 12–26
  10. Stegall HF, Kardon MB, Kemmerer WT. Indirect measurement of arterial blood pressure by Doppler ultrasonic sphygmanometry. J Appl Physiol. 1968;25:793–798
  11. Kazamias TM, Gander MP, Franklin DL, Ross J. Blood pressure measurement with doppler ultrasonic flowmeter. J Appl Phys. 1971;30:585–588
  12. Grüntzig A, Schlumpf M. The validity and reliability of post-stenotic blood pressure measurement by Doppler ultrasonic sphygmomanometry. VASA. 1974;3:65–71
  13. Yao ST, Takaki HS. Non-invasive techniques of measuring lower limb arterial pressures. In:  Bernstein EF editors. Noninvasive Diagnostic Techniques in Peripheral Vascular Disease. 2nd Edn.. St. Louis: Mosby; 1982;
  14. Bonsema K, Boutens EJ, Kaiser V, Stoffers HEJH. Perifeer arterieel vaatlijden. Standaard M13 Nederlands Huisartsen Genootschap. Huisarts Wet. 1990;33:440–446
  15. Bonsema K, Boutens EJ, Kaiser V, Stoffers HEJH. NHG-Standaard Perifeer arterieel vaatlijden. In:  Rutten GEHM,  Thomas S editor. NHG-Standaarden voor de Huisarts. Utrecht, Nederlands: Huisartsen Genootschap/Bunge; 1993;p. 233–244
  16. Stoffers HEJH. Noninvasive vascular tests in general practice. In: Peripheral arterial occlusive disease: prevalence and diagnostic management in general practice. 2nd Edn.. PhD Thesis. Maastricht: Universitaire Pers Maastricht; 1995;p. 27–34
  17. Hylkema BS. Tussen Polspalpatie en Aortografie [Between pulse-palpation and aortography](English summary). In: 2nd Edn.. PhD Thesis. Groningen: Rijksuniversiteit Groningen; 1975;
  18. Bernink PJLM, Wouda AA. Meting van de bloedsomloop in de benen van patiënten met atherosclerosis obliterans, vóór en na de operatie [The reference values and the usefulness of methods of pre- and postoperative determination of the blood circulation in patients with atherosclerosis obliterans](English summary). Ned Tijdschr Geneeskd. 1981;125:1786–1792
  19. Carter SA. Indirect systolic pressures and pulse waves in arterial occlusive disease of the lower extremities. Circulation. 1968;37:624–637
  20. Carter SA. Clinical measurement of systolic pressures in limbs with arterial occlusive disease. JAMA. 1969;207:1869–1874
  21. Yao ST, Hobbs JT, Irvine WT. Ankle systolic pressure measurements in arterial disease affecting the lower extremities. Br J Surg. 1969;56:676–679
  22. Thulesius O, Gjöres JA. Use of doppler shift detection for determining peripheral arterial blood pressure. Angiology. 1971;22:594–603
  23. Chamberlain J, Housley E, MacPherson AIS. The relationship between ultrasound assessment and angiography in occlusive arterial disease of the lower limb. Br J Surg. 1975;62:64–67
  24. Hylkema BS. Diagnostiek van arteriële circulatiestoornissen in de benen door bloeddrukmetingen met behulp van ultrageluid [The diagnosis of obliterative arteriosclerotic disease of the legs by ultrasonic determination of blood pressures](English summary). Ned Tijdschr Geneeskd. 1976;120:733–741
  25. Smith RC, Ferrington C, Ruckley CV. Calf muscle technetium clearance and Doppler ankle pressure in patients with intermittent claudication. VASA. 1977;6:236–243
  26. Ouriël KO, McDonnel AE, Metz CE, Zarins CK. A critical evaluation of stress testing in the diagnosis of peripheral vascular disease. Surgery. 1982;91:686–693
  27. Lepäntelo M, Lindfors O, Pekkola P. The ankle/arm systolic blood pressure ratio as a screening test for arterial insufficiency in the lower limb. Ann Chir Gyn. 1983;72:57–61
  28. Piecuch T, Jaworski R. Resting ankle-arm pressure index in vascular diseases of the lower extremities. Angiology. 1989;40:181–185
  29. Knottnerus JA. The effects of disease verification and referral on the relationship between symptoms and diseases. Med Decis Making. 1987;7:139–148
  30. Knottnerus JA. Medical decision making by general practitioners and specialists. Family Practice. 1991;8:305–307
  31. Fowkes FGR, Housley E, Cawood EHH, Macintyre CCA, Ruckley CV, Prescott RJ. Edinburgh Artery Study: Prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population. Int J Epidemiol. 1991;20:384–392
  32. Newman AB, Sutton-Tyrrel K, Rutan GH, Locher J, Kuller LH. Lower extremity arterial disease in elderly subjects with systolic hypertension. J Clin Epidemiol. 1991;44:15–20
  33. Novo S, Avellone G, Garbo V di, Abrignani MG, Liquori M, Panno AV, et al. Prevalence of risk factors in patients with peripheral arterial disease. A clinical and epidemiological evaluation. Int Angiol. 1992;11:218–229
  34. Postiglione A, Cicerano U, Gallotta G, Gnasso A, Lamenza F, Rubba P, et al. Prevalence of peripheral arterial disease and related risk factors in elderly institutionalized subjects. Gerontology. 1992;38:330–337
  35. Vogt MT, Cauley JA, Kuller LH, Hulley SB. Prevalence and correlates of lower extremity arterial disease in elderly women. Am J Epidemiol. 1993;137:559–568
  36. Fowkes FGR, Housley E, Macintyre CCA, Prescott RJ, Ruckley CV. Variability of ankle and brachial systolic pressures in the measurement of atherosclerotic peripheral arterial disease. J Epidem Community Health. 1988;42:128–133
  37. Stoffers HEJH, Kaiser V, Kester ADM, Schouten HJA, Knottnerus JA. Peripheral arterial occlusive disease in general practice: the reproducibility of the ankle-arm systolic pressure ratio. Scand J Prim Health Care. 1991;9:109–114
  38. Kaiser V, Stoffers HEJH, Knottnerus JA. Peripheral arterial occlusive disease in general practice: Natural course and intervention (the Lim- burg PAOD Study, part II). CVD Epidemiology Newsletter. 1991/1992;47:48–49
  39. Stoffers HEJH. Design, methods and variables. In: Peripheral Arterial Occlusive Disease: Prevalence and Diagnostic Management in General Practice. 2nd Edn.. PhD Thesis. Maastricht: Universitaire Pers Maastricht; 1995;p. 37–49
  40. Stoffers HEJH, Rinkens PELM, Kester ADM, Kaiser V, Knottnerus JA. The prevalence of asymptomatic and unrecognized peripheral arterial occlusive disease. Int J Epidemiol. 1996;25:282–290
  41. Rose GA, Blackburn H, Gillum RF, Prineas RJ. In: 2nd Edn.. Cardiovascular Survey Methods. Geneva: World Health Organization; 1982;p. 162–165
  42. Sox HC, Blatt MA, Higgins MC, Marton KI. Medical Decision Making. Boston: Butterworths; 1988;
  43. Weinstein MC, Fineberg HV. In: 2nd ed.. Clinical Decision Analysis. Philadelphia: Saunders; 1980;
  44. Connell FA, Koepsell TD. Measures of gain in certainty from a diagnostic test. Am J Epidemiol. 1985;121:744–753
  45. Zeger SL, Liang KY. Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986;42:121–130
  46. Karim MR, Zeger SL. In: 2nd ed.. GEE: A SAS Macro for Longitudinal Data Analysis. Baltimore: Johns Hopkins University; 1988;
  47. Gebski V, Leung O, McNeil D, Lunn D. In: 2nd ed.. SPIDA version 6. Eastwood: Statistical Laboratory Maquarie University; 1992;
  48. Hanley JA, McNeil BJ. The meaning and use of the area under the Receiver Operating Characteristic (ROC) curve. Radiology. 1982;143:29–36
  49. Osmundson PhJ, O'Fallon WM, Clements IP, Kazmier FJ, Zimmerman BR, Palumbo PJ. Reproducibility of non-invasive tests of peripheral occlusive vascular disease. J Vasc Surg. 1985;2:678–683
  50. Johnston KW, Hosang MY, Andrews DF. Reproducibility of noninvasive vascular laboratory measurements of the peripheral circulation. J Vasc Surg. 1987;6:147–151
  51. Naschitz JE, Ambrosio DA, Chang JB. Intermittent claudication: Predictors and outcome. Angiology. 1988;39:16–21
  52. Efron B, Tibshirani RJ. In: 2nd ed.. An introduction to the bootstrap. New York: Chapman and Hall; 1993;p. 39–44
  53. Sackett DL, Haynes RB, Tugwell P. In: 2nd ed.. Clinical Epidemiology. A Basic Science for Clinical Medicine. Boston, Toronto: Little, Brown; 1985;
  54. Brown MB, Engelman L, Hill MA, Jennrich RI. In: 2nd ed..  Dixon WJ editors. BMDP Statistical Software Manual. Berkeley: University of California Press; 1990;
  55. Gardner MJ, Gardner SB, Winter PD. In: 2nd ed.. Confidence Interval Analysis (CIA). Microcomputer Program Manual. London: British Medical Journal; 1989;
  56. Stoffers HEJH. General discussion. In: Peripheral Arterial Occlusive Disease: Prevalence and Diagnostic Management in General Practice. 2nd ed.. PhD Thesis. Maastricht: Universitaire Pers Maastricht; 1995;p. 107–128
  57. Newman AB, Siscovick DS, Manolio TA, et al.  Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health Study. Circulation. 1993;88:837–845

☆ The Limburg PAOD Study was financed by the Netherlands Organization for Scientific Research (900-715.154) and the Praeventiefonds (28-1323). Doppler devices were donated by ASTA Medica BV.

PII: S0895-4356(96)00275-2

Journal of Clinical Epidemiology
Volume 49, Issue 12 , Pages 1401-1405 , December 1996

Article Tools