Consistency of Toe Systolic Pressures, Brachial Systolic Pressures, and Toe-Brachial Indices in People with and without Diabetes.

Toe blood pressure ankle-brachial index blood pressure variability brachial blood pressure diabetes intraclass correlation coefficient rater reliability toe-brachial index.

Journal

Current diabetes reviews
ISSN: 1875-6417
Titre abrégé: Curr Diabetes Rev
Pays: United Arab Emirates
ID NLM: 101253260

Informations de publication

Date de publication:
2019
Historique:
received: 18 09 2017
revised: 27 12 2017
accepted: 09 01 2018
pubmed: 24 1 2018
medline: 7 6 2019
entrez: 24 1 2018
Statut: ppublish

Résumé

Toe Systolic Blood Pressures (TSPs) and Toe-Brachial Indices (TBIs) have been identified as useful adjuncts in the identification of pedal ischemia, peripheral artery occlusive diseases, and risk for either nonhealing of lower extremity wounds or for amputation. Valid measurement of TSPs and TBIs is therefore essential. However, it could be jeopardized by rater, instrument, and intratestee inconsistency. These three sources of inconsistency were examined in this research. Five publications addressing TSP and TBI consistency were identified and their results were analyzed using intraclass correlation coefficients. Moderate variability in TSPs was found across all studies; greater variability was evidenced in brachial systolic pressure, particularly for people who had diabetes; and TBI values also exhibited considerable variability, but little difference between people who did and did not have diabetes. These findings provide qualified evidence of consistency regarding measurement of TSPs but challenge TBI as a valid and useful indicator in screening, prognostic, and monitoring contexts, particularly for people who have diabetes. However, there is a prospect that TBI assessment could be improved by adherence to standardized protocols and by obtaining multiple measurements from toes and arms on a single occasion as well as on different occasions.

Sections du résumé

BACKGROUND & AIMS OBJECTIVE
Toe Systolic Blood Pressures (TSPs) and Toe-Brachial Indices (TBIs) have been identified as useful adjuncts in the identification of pedal ischemia, peripheral artery occlusive diseases, and risk for either nonhealing of lower extremity wounds or for amputation. Valid measurement of TSPs and TBIs is therefore essential. However, it could be jeopardized by rater, instrument, and intratestee inconsistency. These three sources of inconsistency were examined in this research.
METHODS METHODS
Five publications addressing TSP and TBI consistency were identified and their results were analyzed using intraclass correlation coefficients.
RESULTS RESULTS
Moderate variability in TSPs was found across all studies; greater variability was evidenced in brachial systolic pressure, particularly for people who had diabetes; and TBI values also exhibited considerable variability, but little difference between people who did and did not have diabetes.
CONCLUSION CONCLUSIONS
These findings provide qualified evidence of consistency regarding measurement of TSPs but challenge TBI as a valid and useful indicator in screening, prognostic, and monitoring contexts, particularly for people who have diabetes. However, there is a prospect that TBI assessment could be improved by adherence to standardized protocols and by obtaining multiple measurements from toes and arms on a single occasion as well as on different occasions.

Identifiants

pubmed: 29359675
pii: CDR-EPUB-88132
doi: 10.2174/1573399814666180123113619
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

85-92

Informations de copyright

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Auteurs

Robert Trevethan (R)

Independent academic researcher and author, Albury, NSW, Australia.

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Classifications MeSH