Screening tests for an accurate diagnosis of peripheral artery disease

NewsBot · Jun 17, 2025

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Which and how many screening tests for an accurate diagnosis of peripheral artery disease in patients with diabetic foot ulcers? A retrospective study.
Benedetta Ragghianti et al
Nutrition, Metabolism and Cardiovascular Diseases 13 June 2025, 104196

Highlights
•Up to 50% of patients with Diabetic Foot Ulcers (DFU) show a PAD, which impairs wound healing.
•Duplex-Ultrasound Scan (DUS), the golden standard for diagnosing PAD,can be performed only by specifically trained healthcare professionals,
•Several bedside diagnostic tests have been developed for overcoming DUS limitations.
•The use of a single bedside test for PAD cannot be sufficiently accrued, as suggested by many guidelines
•Multitesting for the identification of patients with ischemic DFU could be preferable, but never demonstrated.
•This study suggests that the use of combinations of tests can be an interesting alternative in case of limited resources.
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Background
To retrospectively evaluate accuracy of screening tests for peripheral artery disease (PAD) in patients with diabetic foot ulcers (DFUs) and analyze the variation of these parameters when combining more tests together.
Materials and methods
PAD was diagnosed using Duplex-Ultrasound Scan (DUS). The following screening tests were evaluated: ankle systolic pressure, ABI (Ankle-Brachial Index), TP (Toe Pressure), TBI (Toe-Brachial Index), and wave-form analysis (WFA). Sensitivity, specificity, PLR, NLR (Positive and Negative Likelihood Ratio), and accuracy were calculated for each test and for multiple combinations (considering positive those cases in which at least one test was positive).
Results
Out of 97patients, 64 had PAD. TBI, TP, and WFA sensitivity (1.0, 1.0, and 0.83, respectively) and specificity (0.57, 0.43, and 1.0, respectively) were superior to those obtained with ABI (0.82 and 0.64). Among combination of two tests, those of pedal pulses with either TBI or WFA had a better performance than that with ABI. The combination of three tests further increased sensitivity, without reducing specificity.
Conclusions
DUS is the golden standard for diagnosing PAD in patients with DFU. The use of combinations of tests (in particular, WFA+ABI or WFA+TBI) as a first-step can be a valid alternative in case of limited resources.
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NewsBot · Jun 17, 2025

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Screening tests for an accurate diagnosis of peripheral artery disease

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Screening tests for an accurate diagnosis of peripheral artery disease

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

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Share This Page

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