Summary of GRADE profile 10peripheral arterial disease

No. of studiesNo. of patientsPredictor(s)Side of the legSensitivity
(%) [95% CI]
Specificity
(%) [95% CI]
GRADE quality
Clinical examination of PAD (reference standard: AAI ≤ 0.5)
1
[B]
605Abnormal pulses and history of PADRight53
(39 to 68)
91
(88 to 93)
Low
1
[B]
587Abnormal pulses and history of PADLeft50
(35 to 65)
91
(89 to 93)
Low
1
[B]
605Abnormal pulses or history of PADRight93
(86 to 100)
58
(50 to 62)
Low
1
[B]
587Abnormal pulses or history of PADLeft100
(93 to 100)
58
(54 to 62)
Low
1
[B]
605Abnormal pulses and claudication <1 blockRight33
(19 to 46)
95
(93 to 97)
Low
1
[B]
587Abnormal pulses and claudication <1 blockLeft36
(22 to 51)
94
(92 to 96)
Low
1
[B]
605Abnormal pulses or claudication <1 blockRight83
(72 to 94)
71
(67 to 75)
Low
1
[B]
587Abnormal pulses or claudication <1 blockLeft86
(76 to 97)
71
(67 to 75)
Low
No. of studiesNo. of patientsOutcome2 reviewersSensitivity
(%) [95% CI]
Specificity
(%) [95% CI]
GRADE Quality
Diagnostic accuracy of hybrid MRA for critical limb ischaemia (reference standard: DSA)
1
[L]
31Stenoses ≥ 50%195
(86 to 98)
98
(95 to 99)
Low
1
[L]
31Stenoses ≥ 50%296
(88 to 99)
98
(95 to 99)
Low
1
[L]
31Arterial occlusions195
(88 to 97)
98
(96 to 99)
Low
1
[L]
31Arterial occlusions290
(83 to 94)
99
(97 to 100)
Low
No. of studiesNo. of patientsVisualisation of arterial segmentsSensitivity and specificityOther analysisGRADE Quality
Comparison of contrast-enhanced MRA with DSA and change of treatment plans
1
[K]
24Anterior tibial; posterior tibial; peroneal; dorsal pedal; medial plantar; lateral plantar; pedal archN/A
(no reference standard)
MRA was significantly better than DSA for dorsal pedal artery, lateral plantar arteries, and pedal arch, with p < 0.05
MRA revealed a patent vessel that was not seen on DSA (suitable for distal bypass grafting) in 9/24 (38%) patients, which led to a change of treatment plans for 7 patients.
Low

[K] = Kreitner et al. (2006)

AAI = anklearm index; CI = confidence interval; DSA = digital subtraction angiography; MRA = magnetic resonance angiography; PAD = peripheral arterial disease.

From: 3, Evidence review and recommendations

Cover of Diabetic Foot Problems
Diabetic Foot Problems: Inpatient Management of Diabetic Foot Problems.
NICE Clinical Guidelines, No. 119.
Centre for Clinical Practice at NICE (UK).
Copyright © 2011, National Institute for Health and Clinical Excellence.

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