{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:15:56Z","timestamp":1782918956627,"version":"3.54.5"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,11,21]],"date-time":"2021-11-21T00:00:00Z","timestamp":1637452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Backgrounds<\/jats:title><jats:p>Despite numerous studies investigating the use of ultrasound (US) in assessing arteriovenous fistulas (AVF), there are no universally agreed threshold flow velocities in diagnosing significantly abnormal flow that are useful in predicting thrombotic flow\u2010related dysfunction. This study evaluates a predictive model using receiver operating characteristic curve (ROC) analyses to establish threshold velocities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Five hundred and eleven US scans were analysed. ROC curves were used to determine the optimal threshold time average mean velocity (TAMV), peak systolic velocity (PSV) and end diastolic velocity (EDV) of the brachial artery supplying the AVF in determining the need for intervention or thrombosis within 3\u00a0months of the scans. Estimated flow volume (FV) ROC was used as an evaluative comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 356 negative and 155 positive scan results in relation to the need for intervention or thrombosis. Empirical flow velocity parameters of TAMV, EDV and PSV were analysed using ROC curves, yielding an area under the curve (AUC) of 0.95, 0.92 and 0.86, respectively. FV ROC analysis yields a comparative AUC of 0.90. A TAMV cut\u2010off at 48.6\u00a0cm\/s yielded the highest AUC. Subgroup analysis yielded an optimal TAMV cut\u2010off of 45\u2009cm\/s for forearm and 49\u2009cm\/s for arm AVF. The EDV was also highly predictive of outcomes. PSV has the lowest accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The TAMV of inflow brachial artery to AVF is highly predictive of outcomes of thrombotic flow\u2010related dysfunction. Our study confirms TAMV cut\u2010offs of 45\u2009cm\/s for forearm and 49\u2009cm\/s for arm AVF. These results require prospective validation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17378","type":"journal-article","created":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T05:04:20Z","timestamp":1637557460000},"page":"461-465","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Receiver operating characteristic curve analysis of arteriovenous dialysis access flow using ultrasound"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5608-5846","authenticated-orcid":false,"given":"Erwin","family":"Yii","sequence":"first","affiliation":[{"name":"Department of Surgery, School of Clinical Sciences at Monash Health Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming Kon","family":"Yii","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Clinical Sciences at Monash Health Monash University  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