The influence of experience on the reproducibility of the ankle-brachial systolic pressure ratio in peripheral arterial occlusive disease

Objectives: to estimate the intra-observer variability of the measurement o f the ankle-brachial systolic pressure index (ABPI) and to compare the repr oducibility of the measurements by experienced vascular laboratory assistan ts and by less-experienced general practice personnel. Design: repeated measurement of ABPI by general practitioners (GPs), GP-ass istants and vascular laboratory assistants using a pocket Doppler device an d a random-zero sphygmomanometer. Methods and materials: ABPI was measured in six patients with various degre es of PAOD by two experienced observers (vascular laboratory assistants) an d by 24 less-experienced observers (18 practice assistants, sir GPs). Results: the total number of measurements was 354. The overall intra-observ er variability estimate tons 11.8% ABPI. The intra-observer variability was 7.3% in the experienced observers and 12.0% in the less-experienced observ ers. The difference of variability between experienced and less-experienced observers was significant. Conclusions: the ABPI is suitable in follow-up studies where repeated measu rements are needed. Differences between measurements can be minimised by pe rforming repented measurements or by using more experienced observers.