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Can we measure the ankle-brachial index using only a stethoscope? A pilot study
G A L Carmo1, A Mandil, B R Nascimento
1Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. gabriel_carmo@yahoo.com.br
Family Practice
|November 22, 2008
Summary
The ankle-brachial index (ABI) measured with a stethoscope is a useful, accurate method for diagnosing peripheral arterial disease (PAD). This approach shows high sensitivity and specificity, making it suitable for primary care screening.
Area of Science:
- Vascular Medicine
- Diagnostic Accuracy
- Primary Care
Background:
- Ankle-brachial index (ABI) is crucial for diagnosing peripheral arterial disease (PAD).
- Doppler ABI is the current standard but not always accessible in primary care.
- Stethoscope ABI offers an accessible alternative but requires validation.
Purpose of the Study:
- To evaluate the diagnostic accuracy of ABI measured with a stethoscope.
- To compare stethoscope ABI against the Doppler ABI for PAD diagnosis.
- To characterize the performance of the stethoscope ABI method.
Main Methods:
- A diagnostic study comparing stethoscope ABI and Doppler ABI.
- Eighty-eight patients were assessed using both measurement methods.
- Analysis included correlation, sensitivity, specificity, and ROC curve evaluation.
Main Results:
- Stethoscope ABI and Doppler ABI showed good correlation (P = 0.047).
- Sensitivity: 71.4%, Specificity: 91.0%, Positive Predictive Value: 62.5%, Negative Predictive Value: 93.8%.
- Overall study accuracy was 87.7% with an ROC AUC of 0.895 (P < 0.0001).
Conclusions:
- Stethoscope ABI is a valuable tool for detecting PAD.
- This method demonstrates sufficient accuracy for PAD screening in primary care settings.
- The stethoscope ABI is a practical and effective alternative when Doppler is unavailable.
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