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Revista Medica Herediana

On-line version ISSN 1729-214X


POSADAS YABAR, David; PEREZ MUNANTE, Mónica; SOSA VALLE, Héctor  and  TICSE AGUIRRE, Ray. Inter and intra observer variability of the ankle-brachial index measured by palpation using a standardized method. Rev Med Hered [online]. 2013, vol.24, n.3, pp.199-203. ISSN 1729-214X.

Objectives: Determine inter and intra observer variability of the ankle-brachial index measured by palpation using a standardized method (ITBp), and to correlate it with pulse palpation. Methods: 25 patients with risk factors for developing peripheral arterial disease were included in the study. Each observer performed 4 measurements of the ITBp as well as palpation of the peripheral pulse. Intra observer variability was tested with the student’s t-test, and inter observer variability was tested with multivariate analysis of variance. Kappa statistics was used to determine the inter observer concordance of peripheral pulse palpation. Results: 64% of patients were male; mean age was 59.28 ± 10.6; 32% had diabetes mellitus, and 44% had hypertension. Kappa indexes for brachial and dorsalis pedis pulse were 1 and 0.8, respectively. Kappa indexes for posterior tibialis pulse measured by interns and attending physicians was 0.42 and 0.45, respectively. More experienced physicians had lesser overall differences in the intra observer measurements. No difference was observed in the inter observer measurements. Conclusions: Good inter observer correlation to measure ITBp was observed; indicating that using a standardized method reduces variability. A significant intra observer variability of 25% was observed.

Keywords : Ankle brachial index; peripheral artery disease; vascular diseases.

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