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This investigation presents a review of all of the clinical outcome measures used by authors and published in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery from January 1, 2011, to December 31, 2015. Of 1,336 articles published during this time frame, 655 (49.0%) were classified as original research and included in this analysis. Of these 655 articles, 151 (23.1%) included at least one clinical outcome measure. Thirty-seven unique clinical outcome scales were used by authors and published during this period. The most frequently reported scales in the 151 included articles were the American Orthopaedic Foot and Ankle Society scales (54.3%; n = 82), visual analog scale (35.8%; n = 54), Medical Outcomes Study Short Form Health Survey (any version) (10.6%; n = 16), Foot Function Index (5.3%; n = 8), Maryland Foot Score (4.0%; n = 6), and Olerud and Molander scoring system (4.0%; n = 6). Twenty-four articles (15.9%) used some form of original/subjective measure of patient satisfaction/expectation. The results of this investigation detail the considerable variety of clinical outcome measurement tools used by authors in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery and might support the need for a shift toward the consistent use of a smaller number of valid, reliable, and clinically useful scales in the podiatric medical literature.
Background
The objective of this investigation was to determine the level of agreement between a systematic clinical Doppler examination of the foot and ankle and diagnostic peripheral angiography.
Methods
The described Doppler examination technique attempted to determine the patency, quality, and direction of the flow through the dorsalis pedis artery, posterior tibial artery, terminal branches of the peroneal artery, and vascular arch of the foot. These results were then compared with angiographic distal run-off images as interpreted by a blinded vascular surgeon.
Results
Levels of agreement with respect to artery patency/quality ranged from 64.0% to 84.0%. Sensitivity ranged from 53.8% to 84.2%, and specificity ranged from 64.7% to 91.7%. Agreement with respect to arterial flow direction ranged from 73.3% to 90.5%.
Conclusions
We interpret these results to indicate that this comprehensive physical examination technique of the arterial flow to the foot and ankle with a Doppler device might serve as a reasonable initial surrogate to diagnostic angiography in some patients with peripheral arterial disease.
