Responsiveness and Inter-Rater Reliability of the Pulse Volume Recording Upstroke Ratio (PVRr)

Area of Science:

• Vascular Surgery
• Medical Imaging
• Biomedical Engineering

Background:

• Assessing the effectiveness of lower extremity revascularization is crucial for patient outcomes.
• The pulse volume recording upstroke ratio (PVRr) is a potential non-invasive measure for evaluating vascular interventions.
• Standardized validation of PVRr's clinical utility is needed.

Purpose of the Study:

• To evaluate the responsiveness of the pulse volume recording upstroke ratio (PVRr) after lower extremity revascularization.
• To assess the inter-rater reliability of PVRr measurements among healthcare professionals.

Main Methods:

• Analysis of a database of 389 subjects undergoing lower extremity revascularization.
• Inclusion criteria: pedal radiographs, pre- and post-revascularization PVRs, and regular pulsatile digital waveforms.
• Responsiveness assessed by postoperative percent change in PVRr versus digital pressures; reliability assessed via intraclass correlation coefficient (ICC).

Main Results:

• A statistically significant negative correlation (Pearson -0.421; p=0.007) was found between digital pressures and PVRr, indicating responsiveness.
• As digital pressures increased post-revascularization, PVRr decreased.
• High inter-rater reliability for PVRr measurements was observed, with an ICC of 0.960.

Conclusions:

• The pulse volume recording upstroke ratio (PVRr) demonstrates significant responsiveness to changes in digital pressures post-revascularization.
• PVRr exhibits excellent inter-rater reliability, supporting its use as a consistent clinical measurement.
• These findings support the utility of PVRr in evaluating the success of lower extremity revascularization procedures.