Blog | Friday, May 20, 2011

QD: News Every Day--Poll shows split on using the ankle-brachial index


Despite poor awareness and a lack of training on handling peripheral artery disease, internists can and should be able to recognize the symptoms and manage 95% of such cases. Experts advise using the ankle-brachial index as a quick and effective diagnostic method.

Rebecca J. Beyth, ACP Member, demonstrates the ease and quickness of the ankle-brachial index in diagnosing peripheral artery disease. Photo by Eric Zamora/UF News BureauBut internists often don't. As was reported in ACP Internist's previous cover story on the subject, the ankle-brachial index can be a major part of preventing peripheral artery disease, itself a major predictor of strokes and heart attacks, over and above the Framingham risk score.

The ankle-brachial index is the ratio of the ankle to the arm systolic pressure. A ratio of 0.90 or less indicates peripheral artery disease. Its sensitivity is 79% to 95%, and its specificity is 95% to 100%. It takes less than five minutes to perform in the office.

Yet, among the 85 respondents, 36 (42.35%) said "It's a quick and easy test." Another 27 (31.76%) thought, "It's difficult to fit into the standard visit." The final 22 (25.88%) said, "I don't use the ABI to screen patients for PAD."

Illustration by David CutlerFor those who said they don't (or those who don't but didn't vote) take the time to revisit how to conduct an ankle-brachial index exam in our story. And take the time to vote in ACP Internist's latest poll, addressing how internists handle food allergies in their practice.