Circulation, Vol 71, 516-522, Copyright © 1985 by American Heart Association
MH Criqui, A Fronek, MR Klauber, E Barrett-Connor and S Gabriel
In a companion article we have reported the prevalence, in an older,
defined population, of traditional assessments (intermittent claudication
and abnormal pulse examination) of peripheral arterial disease (PAD) as
compared with the results of highly accurate noninvasive testing. In this
article we report the sensitivity, specificity, and positive and negative
predictive values for claudication and abnormal pulses for the diagnosis of
large-vessel and small-vessel PAD as determined by noninvasive testing.
Claudication and abnormal pulses were completely unrelated to isolated
small-vessel PAD. In contrast, both claudication and abnormal pulses were
significantly correlated with large-vessel PAD. Claudication and an
abnormal femoral pulse showed a high specificity and positive predictive
value but a low sensitivity for large-vessel PAD. Conversely, an abnormal
dorsalis pedis pulse showed a good sensitivity but low specificity and
positive predictive value. The best single discriminator was an abnormal
posterior tibial pulse, which had high sensitivity, specificity, and
positive predictive value. Various combinations of claudication and pulse
abnormalities revealed a good sensitivity for broader criteria but at the
expense of specificity, whereas stricter criteria had a good specificity
and positive predictive value but a poor sensitivity. No combination was
superior to an abnormal posterior tibial pulse alone.(ABSTRACT TRUNCATED AT
250 WORDS)
ARTICLES
The sensitivity, specificity, and predictive value of traditional clinical evaluation of peripheral arterial disease: results from noninvasive testing in a defined population
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