Reliability of ankle:brachial pressure index measurement by junior doctors

Br J Surg. 1994 Feb;81(2):188-90. doi: 10.1002/bjs.1800810208.


Ankle:brachial pressure index (ABPI) measurements are often performed by junior medical staff with little experience of the technique. The accuracy of such measurements is unknown. Two newly qualified doctors with no training in the use of Doppler ultrasonographic flowmeters performed ABPI measurement in 38 limbs (experiment 1). Two other newly qualified doctors then underwent a formal training session before, as well as continuous instruction during, ABPI measurements in 23 limbs (experiment 2). The doctors' measurements were compared with those obtained by experienced vascular technicians. The mean difference in ABPI measurement between the doctors and technicians in experiment 1 was greater than that in experiment 2 at both the dorsalis pedis (P < 0.05) and posterior tibial arteries. Nearly 30 per cent of the doctors' ABPI measurements in experiment 1 differed from those of the technicians by more than 0.15, in comparison with only 15 per cent of the measurements performed in experiment 2. Junior doctors should undergo formal training before performing ABPI measurements.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ankle
  • Blood Pressure Determination / standards*
  • Blood Pressure*
  • Brachial Artery
  • Clinical Competence*
  • Humans
  • Medical Staff, Hospital / standards*
  • Middle Aged
  • Observer Variation
  • Sensitivity and Specificity
  • Ultrasonics