1
|
Stansby G, Sims AJ, Wilson L, Beale TAW, Wightman J, Guri I, Wilkes S, Haining S, Allen J. Prospective Assessment of the Diagnostic Accuracy of Multi-site Photoplethysmography Pulse Measurements for Diagnosis of Peripheral Artery Disease in Primary Care. Angiology 2023; 74:859-867. [PMID: 35980897 DOI: 10.1177/00033197221121614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Peripheral arterial disease (PAD) is associated with cerebral and coronary artery disease. Symptomatic PAD affects about 5% of people over 55 years; many more have asymptomatic PAD. Early detection enables modification of arterial disease risk factors. Diagnostically, assessment of symptoms or signs can be unreliable; ankle brachial pressure index (ABPI) testing is time-consuming and few healthcare professionals are properly trained. This study assessed the diagnostic accuracy of multi-site photoplethysmography (MPPG), an alternative non-invasive test for PAD, in primary care. PAD patients identified from general practice registers were age- and sex-matched with controls. Participants were assessed using MPPG, ABPI and duplex ultrasound (DUS). Outcome measures were sensitivity and specificity of MPPG and ABPI (relative to DUS) and concordance. MPPG test results were available in 249 of 298 eligible participants from 16 practices between May 2015 and November 2016. DUS detected PAD in 101/249 (40.6%). MPPG sensitivity was 79.8% (95% confidence interval [CI] 69.9-87.6%), with specificity 71.9% (95% CI 63.7-79.2%). ABPI sensitivity was 80.2% (95% CI 70.8-87.6%), with specificity 88.6% (95% CI 82-93.5%). With comparable sensitivity to ABPI, MPPG is quick, automated and simpler to do than ABPI; it offers the potential for rapid and accessible PAD assessments in primary care.
Collapse
Affiliation(s)
- Gerard Stansby
- Freeman Hospital, Northern Vascular Centre, Newcastle upon Tyne, UK
| | - Andrew J Sims
- Northern Medical Physics and Clinical Engineering, Freeman Hospital, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Lesley Wilson
- Freeman Hospital, Northern Vascular Centre, Newcastle upon Tyne, UK
- Retired Vascular Research Nurse, Northern Vascular Centre, Freeman Hospital, Newcastle upon Tyne, UK
| | - Tom A W Beale
- Northern Medical Physics and Clinical Engineering, Freeman Hospital, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Agilent Technologies LDA UK Limited, Cheadle Royal Business Park, Cheshire, UK
| | - James Wightman
- Northern Medical Physics and Clinical Engineering, Freeman Hospital, Newcastle upon Tyne, UK
| | - Ina Guri
- Northern Medical Physics and Clinical Engineering, Freeman Hospital, Newcastle upon Tyne, UK
- Centre for Stem Cells & Regenerative Medicine (CSCRM), Faculty of Life Sciences & Medicine, King's College London, Great Maze Pond, UK
| | - Scott Wilkes
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Shona Haining
- North of England Commissioning Support (NECS), Newburn Riverside, UK
| | - John Allen
- Northern Medical Physics and Clinical Engineering, Freeman Hospital, Newcastle upon Tyne, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Research Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| |
Collapse
|