{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:17:42Z","timestamp":1792181862585,"version":"4.4.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T00:00:00Z","timestamp":1655856000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100010307","name":"chelsea and westminster health charity","doi-asserted-by":"publisher","award":["0051"],"award-info":[{"award-number":["0051"]}],"id":[{"id":"10.13039\/100010307","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014461","name":"nihr biomedical research centre, royal marsden nhs foundation trust\/institute of cancer research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014461","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Med"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Point-of-care duplex ultrasound has emerged as a promising test for the diagnosis of peripheral artery disease (PAD). However, the interpretation of morphologically diverse Doppler arterial spectral waveforms is challenging and associated with wide inter-observer variation. The aim of this study is to evaluate the utility of machine learning techniques for the diagnosis of PAD from Doppler arterial spectral waveforms sampled at the level of the ankle in patients with diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In two centres, 590 Doppler arterial spectral waveform images (PAD 369, no-PAD 221) from 305 patients were prospectively collected. Doppler arterial spectral waveform signals were reconstructed. Blinded full lower-limb reference duplex ultrasound results were used to label waveform according to PAD status (i.e., PAD, no-PAD). Statistical metrics and multiscale wavelet variance were extracted as discriminatory features. A long short-term memory (LSTM) network was used for the classification of raw signals, and logistic regression (LR) and support vector machines (SVM) were used for classification of extracted features. Signals and feature vectors were randomly divided into training (80%) and testing (20%) sets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The highest overall accuracy was achieved using a logistic regression model with a combination of statistical and multiscale wavelet variance features, with 88% accuracy, 92% sensitivity, and 82% specificity. The area under the receiver operating characteristics curve (AUC) was 0.93.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We have constructed a machine learning algorithm with high discriminatory ability for the diagnosis of PAD using Doppler arterial spectral waveforms sampled at the ankle vessels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1358863x221105113","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T02:41:17Z","timestamp":1655952077000},"page":"450-456","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Machine learning-based classification of arterial spectral waveforms for the diagnosis of peripheral artery disease in the context of diabetes: A proof-of-concept study"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6362-7535","authenticated-orcid":false,"given":"Pasha","family":"Normahani","sequence":"first","affiliation":[{"name":"Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, UK"},{"name":"Department of Surgery and Cancer, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viknesh","family":"Sounderajah","sequence":"additional","affiliation":[{"name":"Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, UK"},{"name":"Department of Surgery and Cancer, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Mandic","sequence":"additional","affiliation":[{"name":"Department of Electrical and Electronic Engineering, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usman","family":"Jaffer","sequence":"additional","affiliation":[{"name":"Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, UK"},{"name":"Department of Surgery and Cancer, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,6,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30255-4"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(90)90492-V"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-0940-0"},{"key":"e_1_3_3_5_2","author":"NHS Digital","year":"2019","unstructured":"NHS Digital. National Diabetes Foot Care Audit: Fourth annual report, https:\/\/digital.nhs.uk\/data-and-information\/clinical-audits-and-registries\/national-diabetes-foot-care-audit (2019, accessed April 1, 2021).","journal-title":"National Diabetes Foot Care Audit: Fourth annual report"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.12.2843"},{"key":"e_1_3_3_7_2","unstructured":"National Institute for Health and Care Excellence (NICE). Peripheral arterial disease: Diagnosis and management. Clinical guideline [CG147] https:\/\/www.nice.org.uk\/guidance\/cg147 (updated 2020 accessed April 1 2021)."},{"key":"e_1_3_3_8_2","unstructured":"National Institute for Health and Care Excellence (NICE). Appendix J: Diabetic foot problems \u2013 full Health Economic Report https:\/\/www.nice.org.uk\/guidance\/ng19\/evidence\/appendix-j-health-economics-pdf-15672915541 (2015 accessed April 1 2021)."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2015.05.004"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2005.09.006"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004545"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004815"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-033753"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csda.2013.09.006"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1162\/neco.1997.9.8.1735"},{"key":"e_1_3_3_16_2","first-page":"1039","article-title":"Application of a transcutaneous Doppler flowmeter in evaluation of occlusive arterial disease","volume":"122","author":"Strandness DEJ","year":"1966","unstructured":"Strandness DEJ, McCutcheon EP, Rushmer RF. Application of a transcutaneous Doppler flowmeter in evaluation of occlusive arterial disease. Surg Gynecol Obstet 1966; 122: 1039\u20131045.","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(67)90272-3"},{"issue":"6","key":"e_1_3_3_18_2","first-page":"447","article-title":"Arterial assessment by Doppler-shift ultrasound","volume":"67","author":"Gosling RG","year":"1974","unstructured":"Gosling RG, King DH. Arterial assessment by Doppler-shift ultrasound. Proc R Soc Med 1974; 67(6 Pt 1): 447\u2013449.","journal-title":"Proc R Soc Med"},{"key":"e_1_3_3_19_2","first-page":"213","volume-title":"Velocimetre ultrasonore Doppler","author":"Pourcelot L","year":"1975","unstructured":"Pourcelot L. Applications cliniques de l\u2019examen Doppler transcutane. In: Peronneau P (ed) Velocimetre ultrasonore Doppler. Seminaire INSERM, 1975, pp.213\u2013240."},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.04.026"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6579\/abf9f3"},{"key":"e_1_3_3_22_2","first-page":"255","article-title":"[College of the French Vascular Medicine Teachers (CEMV) statement: Arterial Doppler waveforms analysis (simplified Saint-Bonnet classification)]","volume":"43","author":"Mah\u00e9 G","year":"2018","unstructured":"Mah\u00e9 G, Boulon C, D\u00e9sormais I, et al. [College of the French Vascular Medicine Teachers (CEMV) statement: Arterial Doppler waveforms analysis (simplified Saint-Bonnet classification)] [Article in French]. 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