UMMS Affiliation

Department of Medicine, Division of Preventive and Behavioral Medicine

Publication Date


Document Type



Ankle Brachial Index; Peripheral Vascular Diseases


Behavioral Disciplines and Activities | Behavior and Behavior Mechanisms | Cardiovascular Diseases | Community Health and Preventive Medicine | Preventive Medicine


The ankle—brachial index (ABI) is a simple, inexpensive diagnostic test for peripheral artery disease (PAD). However, it has shown variable accuracy for identification of significant stenosis. The authors performed a structured review of the sensitivity and specificity of ABI ≤ 0.90 for the diagnosis of PAD. MEDLINE, EMBASE, Cochrane databases, Science Citation Index database, and Biological Abstracts database were searched for studies of the sensitivity and specificity of using ABI ≤ 0.90 for the diagnosis of PAD. Eight studies comprising 2043 patients (or limbs) met the inclusion criteria. The result indicated that, although strict inclusion criteria on studies were formulated, different reference standards were found in these studies, and methods of ABI determination and characteristics of populations varied greatly. A high level of specificity (83.3—99.0%) and accuracy (72.1—89.2%) was reported for an ABI ≤ 0.90 in detecting ≥ 50% stenosis, but there were different levels of sensitivity (15—79%). Sensitivity was low, especially in elderly individuals and patients with diabetes. In conclusion, the test of ABI ≤ 0.90 can be a simple and useful tool to identify PAD with serious stenosis, and may be substituted for other non-invasive tests in clinical practice.

Rights and Permissions

© The Author(s) 2010.

DOI of Published Version



Xu D, Li J, Zou Li, Xu Y, Hu D, Pagoto SL, and Ma Y. Sensitivity and Specificity of the Ankle-brachial Index to Diagnose Peripheral Arterial Disease: a Structured Review. Vascular Medicine, 2010; Oct;15(5):361-9. doi: 10.1177/1358863X10378376 Link to article on publisher's website

Journal/Book/Conference Title

Vascular Medicine