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Optical Methods for Diabetic Foot Ulcer Screening
Published in Andrey V. Dunaev, Valery V. Tuchin, Biomedical Photonics for Diabetes Research, 2023
Robert Bartlett, Gennadi Saiko, Alexandre Yu. Douplik
Early diagnosis of PAD is important because it signals the need to evaluate more central disease of the coronary, renal, and cerebral arteries. The absence of peripheral pulses on the physical examination would support the diagnosis of PAD. However, patients can have significant disease before the pulses disappear. The physical examination as a “test” lacks sensitivity and has a poor agreement between examiners. Better studies are available for PAD screening. The ankle brachial index (ABI) and the handheld Doppler are the commonly used procedures. They have good sensitivity, are inexpensive, and can be performed well at the bedside [24].
Accuracy and repeatability of the Dopplex Ability
Published in Expert Review of Medical Devices, 2018
Rebecca N. Millen, Kate N. Thomas, Arunesh Majumder, Brigid G. Hill, Andre M. Van Rij, Jo Krysa
Peripheral arterial disease (PAD) is a common circulatory disease involving atherosclerosis of the lower limb arteries. There is little epidemiological data on the prevalence of PAD in New Zealand; however, literature of developed countries estimates a prevalence of around 10% in those aged over 65 years, and the prevalence is significantly increasing over time [1]. The consequences of late-stage PAD include arterial ulcers and lower limb ischemia. Ulcer care has been estimated at approximately $1000 USD/month, and revascularization and amputations have been estimated at a cost of approximately $35,000 USD each, with ongoing assisted living costs also significant [2]. Therefore, efficient ways of early diagnosis of PAD would be beneficial in the community clinical setting, to reduce the late-stage complications of the disease. The ankle-brachial index (ABI) is one of the most common tests used to identify PAD, which measures the ratio of the systolic ankle to brachial pressure. It is low cost, non-invasive, and reliable and has a high sensitivity and specificity [2]. Pulse volume recording (PVR) is another useful non-invasive arterial test, based on the volume changes with each pulse in the lower limb using air plethysmography technology [3]. PVR are especially beneficial for assessing lower limb perfusion in patients with non-compressible vessels in whom the ABI cannot be relied upon due to spuriously high values. Despite these advantages, both the ABI and PVR can be time consuming in the primary care setting, and also require specialized equipment and training.