Comparison of Doppler and oscillometric methods of assessing ankle-brachial index in non-diabetic premenopausal women in Ghana

Abstract

Abstract Introduction Peripheral arterial disease (PAD) is a common cardiovascular disease less commonly diagnosed in female patients. PAD 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 two methods is less investigated in sub-Saharan African poplation. Therefore, we compared the diagnostic characteristics of the oscillometric method of measuring ABI with the Doppler method in premenopausal female patients suspected of PAD in Ghana. Method ABI was measured in non-diabetic premenopausal women suspected of PAD using the Doppler method with a 8 MHz handheld Doppler (LifeDop 250, Summit Doppler) and an oscillometric device (Vasera 1500N, Fukuda Denshi) in 160 patients (320 legs). PAD was defined as ABI < 0.9 in at least one leg. Leg pains 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 to the Doppler method, the accuracy of the oscillometric method was 88.2%, with sensitivity, specificity, positive and negative predictive values of 89.7%, 87.6%, 71.4% and 96.1%, respectively. The overall agreement between the Doppler and oscillometric methods was high [\(\kappa\)=0.78 (0.62–0.91), p < 0.001] and intraclass correlation of 0.89 (0.87–0.92, p < 0.001). In ROC curve analysis, the oscillometric method showed an area under curve of 0.925 compared to the Doppler method in the diagnosis of PAD. Conclusion In nondiabetic premenopausal women in our study, oscillometric ABI performed acceptably in the diagnosis of PAD when compared with Doppler ABI.