{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:05:38Z","timestamp":1790611538062,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,5,2]],"date-time":"2018-05-02T00:00:00Z","timestamp":1525219200000},"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":["Diabet. Med."],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Peripheral artery disease is common in people with diabetes\u2010related foot ulceration and is a risk factor for amputation. The best method for the detection or exclusion of peripheral artery disease is unknown. This study investigated the utility of clinical examination and non\u2010invasive bedside tests in screening for peripheral artery disease in diabetes\u2010related foot ulceration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Some 60 people presenting with new\u2010onset ulceration participated. Accuracy of pulses, ankle pressure, toe pressure, toe\u2013brachial index (<jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content>), ankle\u2013brachial pressure index (<jats:styled-content style=\"fixed-case\">ABPI<\/jats:styled-content>), pole test at ankle, transcutaneous oxygen pressure and distal tibial waveform on ultrasound were examined. The gold standard diagnostic test used was &gt; 50% stenosis in any artery or monophasic flow distal to calcification in any ipsilateral vessel on duplex ultrasound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The negative and positive likelihood ratios of pedal pulse assessment (0.75, 1.38) and the other clinical assessment tools were poor. The negative and positive likelihood ratios of <jats:styled-content style=\"fixed-case\">ABPI<\/jats:styled-content> (0.53, 1.69), transcutaneous oxygen pressure (1.10, 0.81) and ankle pressure (0.67, 2.25) were unsatisfactory. The lowest negative likelihood ratios were for tibial waveform assessment (0.15) and <jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content> (0.24). The highest positive likelihood ratios were for toe pressure (17.55) and pole test at the ankle (10.29) but the negative likelihood ratios were poor at 0.56 and 0.74.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pulse assessment and <jats:styled-content style=\"fixed-case\">ABPI<\/jats:styled-content> have limited utility in the detection of peripheral artery disease in people with diabetes foot ulceration. <jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content> and distal tibial waveforms are useful for selecting those needing diagnostic testing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13634","type":"journal-article","created":{"date-parts":[[2018,4,10]],"date-time":"2018-04-10T06:27:50Z","timestamp":1523341670000},"page":"895-902","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Clinical examination and non\u2010invasive screening tests in the diagnosis of peripheral artery disease in people with diabetes\u2010related foot ulceration"],"prefix":"10.1111","volume":"35","author":[{"given":"B.","family":"Vriens","sequence":"first","affiliation":[{"name":"Vascular Department Colchester General Hospital Colchester Hospital University NHS Foundation Trust Colchester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"D'Abate","sequence":"additional","affiliation":[{"name":"St. George's Vascular Institute St. George's Hospital St. George's University NHS Foundation Trust London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0982-4482","authenticated-orcid":false,"given":"B. A.","family":"Ozdemir","sequence":"additional","affiliation":[{"name":"St. George's Vascular Institute St. George's Hospital St. George's University NHS Foundation Trust London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Fenner","sequence":"additional","affiliation":[{"name":"St. George's Vascular Institute St. George's Hospital St. George's University NHS Foundation Trust London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Maynard","sequence":"additional","affiliation":[{"name":"St. George's Vascular Institute St. George's Hospital St. George's University NHS Foundation Trust London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Budge","sequence":"additional","affiliation":[{"name":"St. George's Vascular Institute St. George's Hospital St. George's University NHS Foundation Trust London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Carradice","sequence":"additional","affiliation":[{"name":"Academic Vascular Surgical Unit Hull York Medical School Hull"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. J.","family":"Hinchliffe","sequence":"additional","affiliation":[{"name":"Bristol Centre for Surgical Research University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60679-X"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.1995.tb02079.x"},{"key":"e_1_2_9_4_1","unstructured":"Diabetes UK.Improving footcare for people with diabetes and saving money: an economic study in England. 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