Inter-rater reliability of automated devices for measurement of toe systolic blood pressure and the toe brachial index.

Abstract

The aim of this study was to determine the inter-rater reliability of automated devices for the measurement of toe systolic blood pressure (TSBP) and the toe brachial index (TBI). Toe and brachial systolic blood pressures were measured in 40 participants by two podiatrists using SysToe and MicroLife automated devices. Intraclass correlation coefficients (ICC) with a 95% confidence interval (CI) and 95% limits of agreement (LOA) were determined for TSBP, brachial systolic blood pressure and the TBI. The inter-rater reliability of all measurements was excellent, with ICCs ranging from 0.82 to 0.85. TSBP had the greatest reliability (ICC: 0.85, 95% CI: 0.74-0.92, 95% LOA: -14.4 to 21.1 mmHg) and brachial blood pressures had the lowest reliability (ICC: 0.82, 95% CI: 0.68-0.90, 95% LOA: -21.2 to 22.9 mmHg). The inter-rater reliability of the TBI fell between the TSBP and the brachial blood pressure reliability (ICC: 0.83, 95% CI: 0.70-0.90, 95% LOA: -0.16 to 0.20). We showed that automated devices for the measurement of toe and brachial systolic blood pressure and the TBI in a clinical setting produce measurements with high inter-rater reliability. These findings support the use of these automated devices for ongoing monitoring of lower extremity vascular status.