Comparison of Doppler and Oscillometric Methods of Assessing Ankle-Brachial Index in Non-diabetic Premenopausal Women in Ghana
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Date
2023
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Publisher
SAGE Publications Ltd
Abstract
Abstract
Introduction: Peripheral arterial disease (PAD) is a common cardiovascular disorder less commonly diagnosed in female
patients. Peripheral arterial disease is objectively diagnosed using the ankle-brachial index (ABI), which can be measured using
the “gold standard” Doppler method or the oscillometric method. The agreement between these 2 methods is less investigated
in the sub-Saharan African population. Therefore, we compared the diagnostic characteristics of the oscillometric method of
measuring ABI with the Doppler method in premenopausal female patients in Ghana. Methods: The ABI was measured in
non-diabetic premenopausal women suspected of having PAD using the Doppler method with an 8 MHz handheld Doppler
(LifeDop 250, Summit Doppler) and an oscillometric device (Vasera 1500N, Fukuda Denshi) in 160 patients (320 legs). Peripheral
arterial disease was defined as an ABI <0.90 in at least one leg. Leg symptoms were assessed using the Edinburgh claudication
questionnaire. Results: Leg pain on exertion was present in 101 patients screened with similar mean ABIs in the right and
left legs. The prevalence of PAD as screened by the Doppler method was 25.7% (18.9%-33.4%) and that of the oscillometric
method was 32.2% (24.9%-40.3%). In comparison with the Doppler method, the accuracy of the oscillometric method was
88.2%, and the sensitivity, specificity, positive predictive value, and negative predictive value were 89.7%, 87.6%, 71.4%, and
96.1%, respectively. The overall agreement between the Doppler and oscillometric methods was high, = 0.78 (0.62-0.91), P <
.001, with an intraclass correlation of 0.89 (0.87-0.92, P < .001). In receiver-operating characteristic (ROC) curve analysis, the
oscillometric method showed an area under the curve of 0.925 compared with the Doppler method in the diagnosis of PAD.
Conclusion: In non-diabetic premenopausal women in our study, oscillometric ABI performed acceptably in the diagnosis of
PAD when compared with Doppler ABI.
Description
Research Article
Keywords
Peripheral arterial disease, Ankle-brachial index, Doppler ultrasound, Oscillometric blood pressure, Claudication