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Interrater Reliability of Spectral Doppler Waveform

Analysis Among Podiatric Clinicians

Cynthia Formosa Faculty of Health Sciences, University of Malta, Msida, Malta.

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Christian Ellul Faculty of Health Sciences, University of Malta, Msida, Malta.

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Anabelle Mizzi Faculty of Health Sciences, University of Malta, Msida, Malta.

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Stephen Mizzi Faculty of Health Sciences, University of Malta, Msida, Malta.

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Alfred Gatt Faculty of Health Sciences, University of Malta, Msida, Malta.

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Background:

Spectral Doppler ultrasound examination of pedal arteries is one of the most frequently used noninvasive assessment methods by health-care professionals for the diagnosis and ongoing monitoring of people at risk for or living with peripheral arterial disease. The aim of this study was to determine the interrater reliability of the interpretation of spectral Doppler waveform analysis.

Methods:

An interrater reliability study was conducted among five experienced podiatric physicians at the University of Malta Research Laboratory (Msida, Malta). A researcher who was not a rater in this study randomly selected 229 printed spectral Doppler waveforms from a database held at the University of Malta. Each rater independently rated the qualitative spectral waveforms.

Results:

Interrater reliability of the spectral Doppler waveform interpretation was excellent among the five experienced podiatric physicians (α = 0.98). The intraclass correlation coefficient showed a high degree of correlation in waveform interpretation across raters (P < .001).

Conclusions:

This study demonstrates high interrater reliability in visual spectral Doppler interpretation among experienced clinicians. The current foot screening guidelines do not refer to spectral Doppler waveform analysis in their recommendations, which has been shown in studies to be an important modality for the diagnosis of peripheral arterial disease when ankle-brachial pressure indexes are falsely elevated in calcified arteries. If interpreted correctly, the information obtained can provide an indication of the presence of peripheral arterial disease and facilitate early management of this condition.

Corresponding author: Cynthia Formosa, PhD, Faculty of Health Sciences, University of Malta, Tal-Qroqq, Msida, MSD 2080, Malta. (E-mail: cynthia.formosa@um.edu.mt)