Imperial College London
Alternate

Professor Alun H Davies, MA,DM,DSc,FRCS,FHEA,FEBVS,FACPh

Faculty of Medicine, Department of Surgery & Cancer

Professor of Vascular Surgery
 
 
 
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Contact

 

+44 (0)20 3311 7309a.h.davies

 
 
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Location

 

4E04 EastEast WingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Elghazaly:2023:10.1136/bmjdrc-2022-003110,
author = {Elghazaly, H and Howard, T and Sharan, S and Mohamed, O and Sounderajah, V and Mehar, Z and Davies, A and Jaffer, U and Normahani, P},
doi = {10.1136/bmjdrc-2022-003110},
journal = {BMJ Open Diabetes Research and Care},
pages = {1--11},
title = {Evaluating the prognostic performance of bedside tests used for peripheral arterial disease diagnosis in the prediction of diabetic foot ulcer healing},
url = {http://dx.doi.org/10.1136/bmjdrc-2022-003110},
volume = {11},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Introduction:Diabetic foot ulceration (DFU) is a common and challenging complication of diabetes. Risk stratification can guide further management. We aim to evaluate the prognostic performance of bedside tests used for peripheral arterial disease (PAD) diagnosis to predict DFU healing.Research Design and Methods:TrEAD was a prospective observational study comparing the diagnostic performance of commonly-used tests for PAD diagnosis. We performed a secondary analysis assessing whether these could predict DFU healing. Follow-up was performed prospectively for 12-months. The primary outcome was sensitivity for predicting ulcer healing. Secondary endpoints were specificity, predictive values, and likelihood ratios for ulcer healing.Results:123 of TrEAD participants with DFU were included. In 12-months, 52.8% of ulcers healed. The best negative diagnostic likelihood ratio was observed for the PAD-scan (mono or biphasic with adverse features) (NDLR 0.35, 95% CI 0.14-0.90). The highest positive likelihood ratios were observed for TBPI of 0.2 (PDLR 7.67, 95% CI 0.91-64.84) and TcPO2 of 20mmHg (PDLR 2.68, 95% CI 0.54-13.25). Cox proportional hazard modelling demonstrated significantly greater probabilities of healing with triphasic waveforms (HR = 2.54, 95% CI 1.23 – 5.3, p=0.012) and biphasic waveforms with non-adverse features (HR = 13.67, 95% CI 4.78 – 39.1, p<0.001) on PAD-scan.  Conclusions:No single test performed well enough to be used in isolation as a prognostic marker for the prediction of DFU healing.
AU  - Elghazaly,H
AU  - Howard,T
AU  - Sharan,S
AU  - Mohamed,O
AU  - Sounderajah,V
AU  - Mehar,Z
AU  - Davies,A
AU  - Jaffer,U
AU  - Normahani,P
DO  - 10.1136/bmjdrc-2022-003110
EP  - 11
PY  - 2023///
SN  - 2052-4897
SP  - 1
TI  - Evaluating the prognostic performance of bedside tests used for peripheral arterial disease diagnosis in the prediction of diabetic foot ulcer healing
T2  - BMJ Open Diabetes Research and Care
UR  - http://dx.doi.org/10.1136/bmjdrc-2022-003110
UR  - https://drc.bmj.com/content/11/2/e003110
UR  - http://hdl.handle.net/10044/1/102725
VL  - 11
ER  -
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