Introduction/background
Objectives
Methods
Search strategy
Databases: MEDLINE (1946+), EMBASE (1947+), and CINAHL Complete | |
---|---|
1 | Ankle brachial pressure |
2 | Ankle arm pressure |
3 | Ankle brachial ind* |
4 | Reliab* |
5 | Consistenc* |
6 | Accura* |
7 | Reproduc* |
8 | Repeat* |
9 | Agreement |
10 | Precision |
11 | 1 or 2 or 3 AND 4 or 5 or 6 or 7 or 8 or 9 or 10 |
Inclusion and exclusion criteria
Other sources
Data collection and analysis
Methodological quality assessment
Results
Characteristics and overview of included studies
Reference | Number (n) | Gender (M,F) | Age (years) | Height (cm) | Weight (kg) | DM & control | DM duration | Medical history | PAD | Reliability measure |
---|---|---|---|---|---|---|---|---|---|---|
Inter-rater reliability (n = 11) | ||||||||||
Aboyans et al. (2008) [13] | 54 | 28, 26 | 52.8 ± 17.1 | NR | NR | DM 35.2% control NR | NR | HT 38.9%, DL 38.9%, CAD 33.3% CVD 11.1% TS 22.2%, | 19 IC, 25 RF, 10 healthy | ICC Doppler: Inter: 0.79 (0.70–0.85) Pulse: inter: 0.40 (0.5–0.57) Auto ABI inter: 0.44 (0.27–0.58) |
Alvaro-Afonso et al. (2018) [51] | 21 | 15, 6 | 67 ± 8.7 | NR | NR | All DM2: control NR | NR | HT 19, DL 17, NEU 18, NEP 1, TS 6 | NR | Kappa coefficient Normal: 0.4 (p < 0.001), PAD 0.7 (p < 0.001), MAC 0.43 (p < 0.001) |
Chesbro et al. (2011) [46] | 20 | NR | 22–30 | NR | NR | NR | NR | Healthy volunteers only | None | ICC Doppler: R: 1.00 (95%CI 0.999–1.00, p < .001); L: 0.99 (0.997–1.00, p < .001) |
Chesbro et al. (2013) [56] | 10 | 5, 5 | NR | NR | NR | NR | NR | ‘Healthy young adults’ | None | ICC Vascular Cuff Right: Trial 1: 0.853; Trial 2: 0.898 Left: Trial 1: 0.448; Trial 2: 0.938 Standard Cuff Right: Trial 1: 0.902; Trial 2:0.817 Left: Trial 1: 0.826; Trial 2: 0.867 |
de Graff et al. (2001) [57] | 54 | 31, 23 | 66 ± 12 | NR | NR | DM 36% control NR | NR | HT 43%, Dl 35%, CAD 36%, CVD 20%, | Suspected | Repeatability Coefficient/ICC Inter: day 20 / 0.92 Inter: week 27 / 0.87 |
Georgakarakos et al. (2013) [47] | 18 | 12, 6 | 54–74 | NR | NR | 9 DM: 3 oral, 6 insulin | NR | HT 15, DL 9, TS 4 | All PAD | Mean, Standard Error, t-test PAD: 0.77 ± 0.19, p = 0.95 No PAD: 1.37 ± 0.12, p < 0.0001 Severe PAD: 0.23 ± 0.07, p = 0.0002 |
Holland-Letz et al. (2007) [16] | 108 | 50, 58 | 68.1 ± 1.5 | NR | BMI 29 ± 4.3 | DM 15.7% control NR | NR | HT 58.1% DL 54.8%, TS 9.2% current, 40.7% ex-, Hx vasc surg 6 subjects | 68.1 ± 1.5 | ICC for inter-observer: 0.423 Inter-ob SD 0.103 |
Jaffer et al. (2008) [50] | 25 | NR | NR | NR | NR | NR | NR | NR | All suspected PAD | Pearson CC r = 0.516 (p < 0.001) |
Langen et al. (2009) [48] | 20 | 11, 9 | 41–75 | NR | NR | NR | NR | NR | All IC Symptoms | Interobserver variability: 10% (SD 0.8) |
Mätzke et al. (2003) [12] | 30 | 18, 15 (no of limbs) | 26 > 65 yrs., 7 ≤ 65 yrs | NR | NR | 8 DM, control NR | NR | NR | Ischaemic pressure lesion or rest pain | Coefficient of variation: 3.2 |
Span et al. (2016) [49] | 136 | NR | 64 ± 7.8 | NR | NR | 19 (14%) control not reported | NR | HT66, DL 58, TS 22 current, 39 ex- | RF or IC | Coefficient of variation Doppler: 5.9% R & L legs Auto: Right 3.2% Left 3.5% |
Intra-rater reliability (n = 8) | ||||||||||
Aboyans et al. (2008) [13] | 54 | 28, 26 | 52.8 ± 17.1 | NR | NR | DM 35.2% control NR | NR | HT 38.9%, DL 38.9%, CAD 33.3% CVD 11.1% TS 22.2%, | 19 IC, 25 RF, 10 healthy | ICC Doppler: Intra: 0.89 (0.84–0.92) Pulse: Intra: 0.60 (0.44–0.73), |
Chesbro et al. (2013) [56] | 10 | 5, 5 | NR | NR | NR | NR | NR | ‘Healthy young adults’ | None | ICC- Intra-rater Vascular Cuff Rater 1 R: 0.750; Rater 1 R: 0.696 Rater 2 R: 0.551; Rater 2 L: 0.869 Standard Cuff Rater 1 R: 0.628; Rater 1 L: 0.420 Rater 2 R: 0.620; Rater 2 L:0.585 |
de Graff et al. (2001) [57] | 54 | 31, 23 | 66 ± 12 | NR | NR | DM 36% control NR | NR | HT 43%, Dl 35%, CAD 36%, CVD 20%, | Suspected | Repeatability Coefficient/ICC Intra: day 9 / 0.98 Intra: week 22 / 0.89 |
Demir et al. (2016) [52] | 161 | 87, 74 | 52.03 ± 18.99 | 165.12 ± 8.88 | 75.61 ± 13.4 | DM NR | NR | HT 62.7%, DL 46.6%, TS 29.8%, | Mixed population | ICC Single measurement 0.808 Mean: 0.927 |
Faccenda et al. (1988) [53] | 36 | 28,8 | 56 ± 11 | NR | NR | All DM1 | NR | No other hx reported | NR | Coefficient of variation 8% |
Holland-Letz et al. (2007) [16] | 108 | 50, 58 | 68.1 ± 1.5 | NR | BMI 29 ± 4.3 | DM 15.7% control NR | NR | HT 58.1% DL 54.8%, TS 9.2% current, 40.7% ex-, Hx vasc surg 6 subjects | 68.1 ± 1.5 | Intra-observer Variance: 0.008, SD 0.87 [0.081; 0.095] |
Millen et al. (2018) [54] | 66 | 51, 15 | 69.5 ± 12 yrs. (range 35–92) | NR | NR | 4 DM1, 14 DM2 | HT 79%, DL 68%, CAD 44%, CVD 17%, TS 15% current, 59% ex- | 36 IC, 4 rest pain | Coefficient of variation: Dopplex Ability: 9.65 ± 12% Parks Flo-lab: 4.95 ± 3% | |
Rosenbaum et al. (2012) [55] | 157 | 80, 77 | 59.1 ± 13.2 | NR | NR | 35 DM, control NR | NR | HT88, DL 103, CAD 14, CVD 2, TS 27 current, 49 ex- | 11 PAD, all RF or IC | Coefficient of variation: Dopplex Ability: 9.65 ± 12% Parks Flo-lab: 4.95 ± 3% |
Methodological quality
Item | Aboyans et al. (2008) [13] | Alvaro-Afonso et al. (2018) [51] | Chesbro et al. (2011) [46] | Chesbro et al. (2013) [56] | de Graaff et al. 2001) [57] | Demir et al. (2016) [52] | Faccenda et al. (1988) [53] | Georgakarakos et al. (2013) [47] | Holland-Letz et al. (2007) [16] | Jaffer et al. (2008) [50] | Langen et al (2009) [48] | Matzke et al. (2003) [12] | Millen et al. (2018) [54] | Rosenbaum et al. (2012) [55] | Span et al. (2016) [49] |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1. Was the test evaluated in a sample of subjects who were representative of those to whom the authors intended the results to be applied? | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
2. Was the test performed by raters who were representative of those to whom the authors intended the results to be applied? | Y | U | Y | Y | Y | Y | U | Y | Y | Y | Y | Y | Y | Y | Y |
3. Were raters blinded to the findings of other raters during the study? | Y | U | Y | Y | Y | NA | NA | Y | U | U | Y | Y | Y | NA | Y |
4. Were raters blinded to their own prior findings of the test under evaluation? | Y | NA | U | U | U | U | Y | NA | Y | NA | NA | NA | NA | U | Y |
5. Were raters blinded to the results of the reference standard for the target disorder (or variable) being evaluated? | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
6. Were raters blinded to clinical information that was not intended to be provided as part of the testing procedure or study design? | U | U | U | U | U | U | U | U | U | U | U | Y | N | U | U |
7. Were raters blinded to additional cues that were not part of the test? | U | U | U | U | U | U | U | U | U | U | U | U | N | U | U |
8. Was the order of examination varied? | U | U | Y | Y | U | N | U | U | U | U | N | U | Y | U | U |
9. Was the time interval between repeated measurements compatible with the stability (or theoretical stability) of the variable being measured? | U | Y | Y | Y | Y | Y | Y | Y | Y | U | Y | U | Y | U | U |
10. Was the test applied correctly and interpreted appropriately? | N | Y | Y | Y | Y | Y | N | Y | N | U | Y | Y | Y | N | Y |
11. Were appropriate statistical measures of agreement used? | Y | Y | Y | Y | Y | Y | P | Y | Y | Y | U | N | Y | Y | Y |