Peripheral Arterial Disease: Sensitivity and Specificity

Introduction: None written.

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Prevalence

Population / Calculator	Prevalence	Comments / Study / Link
Symptomatic adults age 60-80	15%	JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619
Asymptomatic Adults, age 60-69	5%	JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619
More populations	0%	see table 5 in JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619
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The sensitivity and specificity of findings for Peripheral Arterial Disease are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Ankle-Brachial Index

95%

100%

Threshold < 0.9

With the patient lying supine, a sphygmomanometer cuff, placed 2 to 3 cm above the point of pulse measurement, is inflated above the systolic pressure. As the cuff pressure is slowly released, a handheld Doppler is used for obtaining the systolic pressure at the right and left ankle (either dorsalis pedis artery, posterior tibial artery, or both) and the right and left brachial artery. The systolic pressure is that pressure where the Doppler signal returns.

Study: JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619

CT angiography

95%

96%

most of data from patients with intermittent claudication

Study: JAMA. 2009;301(4):415-424. http://jama.ama-assn.org/cgi/content/short/301/4/415

Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Skin Wounds	2%	100%	in symptomatic patients Study: JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619
Skin Temperature	9%	98%	i.e. cooler to touch, in symptomatic patients Study: JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619
Femoral Bruit Duplicate	21%	96%	in a screening population Study: JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619
Femoral Bruit Duplicate	30%	95%	in symptomatic patients Study: JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619
Intermittent Claudication	15%	95%	reproducible leg pain that occurs with exercise, does not occur at rest, and is relieved within 10 minutes of rest (in a screening population) Study: JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619
Peripheral Artery Disease Score	82%	89%	< 6 of the following in asymptomatic patients: The number of auscultated components (right posterior tibial artery + left posterior tibial artery; range of 0 for none heard to 3 for normal for each artery) plus The grade of palpated posterior tibial artery (right posterior tibial artery + left posterior tibial artery; 2 for normal, 1 for palpated but abnormal, 0 for not palpable for each artery) plus A history of myocardial infarction (1 for none, 0 for prior myocardial infarction) Study: JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619
Palpable Pulse Abnormality Duplicate	67%	86%	"any palpable pulse abnormality", in symptomatic patients Study: JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619

Sensitive Findings

Skin Discoloration

100%

64%

symptomatic patients

Study: JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619

Poorly Diagnostic Findings

Capillary refill time

35%

82%

abnormal. For moderate-severe PAD. In symptomatic patients.

Study: JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619

Palpable Pulse Abnormality
Duplicate

66%

78%

"any palpable pulse abnormality", in a screening population

Study: JAMA. 2006 Feb 1;295(5):536-46. PMID: 16449619