Association of FTO and IRX3 genetic variants to obesity risk in north India

Abstract

Objective: Validation of body adiposity index (BAI) in a paediatrics sample; and to develop, if necessary, a valid BAI for paediatrics (i.e. BAI_p).

Methods: A total of 1615 children (52% boys) aged 5–12 years underwent anthropometry. Their body composition was assessed using a foot-to-foot bioimpedance. The validity of BAI?=?(Hip circumference/Height^1.5)???18 was tested by combining correlation and agreement statistics. Then, the sample was split into two sub-samples for the construction of BAI_p. A regression was used to compute the prediction equation for BAI_p-based percentage of body fat (%BF).

Results: The initial BAI over-estimated the %BF of children by 49% (29.6?±?4.2% versus 19.8?±?6.8%; p?<?0.0001). The original methodology led to a BAI_p?=?(Hip circumference/Height^0.8) ? 38 in children. When compared to BAI, BAI_p showed both better correlation (r?=?0.57; p?<?0.01 versus r?=?0.74; p?<?0.0001) and agreement (ICC?=?0.34; [95% CI?=??0.19–0.65] versus ICC?=?0.83; [95% CI?=?0.81–0.84]). However, there were some systematic biases between the two values of %BF as exemplified by the large 95% limit of agreement [?9.1%; 8.8%] obtained.

Conclusion: BAI over-estimates the %BF in children. In contrast, BAI_p appears as a new index for children’s body fatness, with acceptable accuracy. In its current form, this index is valid only for large-scale studies.     

Real-life step and activity measurement: reliability and validity

Objectives: Investigation of the reliability and validity of activity monitoring using a range of methods, namely manual counting, self report and two commercially available activity monitors.

Study design: Reliability, accuracy and validity study.

Methods: Multiple convenience samples of healthy subjects were recruited to the study. Reliability of manual step count was determined using an intraclass correlation coefficient (ICC) (n = 10). Relationships between data from the Step Watch? monitor (SAM) and (a) manual step counts (n = 18); (b) a second (different) activity monitor (ActivPAL); and (c) self reported activity levels (n = 22) were assessed using correlations. A Pearson's correlation and paired t-test was used to assess relations between routinely used monitors.

Results: Intra-rater reliability for manual step counts was excellent (ICC 0.99), but inter-rater reliability was poor (ICC 0.26). Indoor accuracy of the SAM was 96.06% and outdoor accuracy was 99.58%. Moderate correlations (rho = 0.423 to 0.595, p < 0.05) were identified between the SAM monitor activity levels and self report diaries. The SAM and the ActivPAL were found to be internally reliable within themselves (ICC 0.96 and 0.95 respectively), significantly correlated (r = 0.93, p < 0.001) but also significantly different (t = 2.179, p < 0.05) when used simultaneously over the same circuit.

Conclusions: Activity monitors provide information that is related to actual activity and provide accurate and reliable data when tested on functional walking circuits. Activity monitors should not be used interchangeably due to the potential for systematic differences between the measurements obtained when applied simultaneously over the same repeated circuit.     

Reliability and concurrent validity of a new iPhone® goniometric application for measuring active wrist range of motion: a cross‐sectional study in asymptomatic subjects

Measurement of wrist range of motion (ROM) is often considered to be an essential component of wrist physical examination. The measurement can be carried out through various instruments such as goniometers and inclinometers. Recent smartphones have been equipped with accelerometers and magnetometers, which, through specific software applications (apps) can be used for goniometric functions. This study, for the first time, aimed to evaluate the reliability and concurrent validity of a new smartphone goniometric app (Goniometer Pro©) for measuring active wrist ROM. In all, 120 wrists of 70 asymptomatic adults (38 men and 32 women; aged 18–40 years) were assessed in a physiotherapy clinic located at the School of Rehabilitation Sciences, Iran University of Medical Science and Health Services, Tehran, Iran. Following the recruitment process, active wrist ROM was measured using a universal goniometer and iPhone^® 5 app. Two blinded examiners each utilized the universal goniometer and iPhone^® to measure active wrist ROM using a volar/dorsal alignment technique in the following sequences: flexion, extension, radial deviation, and ulnar deviation. The second (2 h later) and third (48 h later) sessions were carried out in the same manner as the first session. All the measurements were conducted three times and the mean value of three repetitions for each measurement was used for analysis. Intraclass correlation coefficient (ICC) models (3, k) and (2, k) were used to determine the intra‐rater and inter‐rater reliability, respectively. The Pearson correlation coefficients were used to establish concurrent validity of the iPhone^® app. Good to excellent intra‐rater and inter‐rater reliability was demonstrated for the goniometer with ICC values of ≥ 0.82 and ≥ 0.73 and the iPhone^® app with ICC values of ≥ 0.83 and ≥ 0.79, respectively. Minimum detectable change at the 95% confidence level (MDC₉₅) was computed as 1.96 × standard error of measurement × √2. The MDC₉₅ ranged from 1.66° to 5.35° for the intra‐rater analysis and from 1.97° to 6.15° for the inter‐rater analysis. The concurrent validity between the two instruments was high, with r values of ≥ 0.80. From the results of this cross‐sectional study, it can be concluded that the iPhone^® app possesses good to excellent intra‐rater and inter‐rater reliability and concurrent validity. It seems that this app can be used for the measurement of wrist ROM. However, further research is needed to evaluate symptomatic subjects using this app.     

Cross-cultural adaptation of the Greek version of the Knee Outcome Survey – Activities of Daily Living Scale (KOS-ADLS)

The purpose of this study was to cross-culturally adapt and validate the Greek version of Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS), a self-reported instrument used for patients with various knee pathological conditions including osteoarthritis. Ninety-four patients (57 males and 37 females) with a variety of pathological knee disorders and impairments being referred to physical therapy for evaluation and treatment were included in the study. For the crοss-cultural translation, a back-translation procedure was utilized by 3 bi-lingual translators. To assess test–retest reliability the patients were asked to complete the KOS-ADLS twice at initial visit; before and after physiotherapy treatment. To assess responsiveness, patients completed the KOS-ADLS at the end of all physiotherapy sessions and the score was compared with KOS-ADLS at initial (pre-treatment) visit. Finally, concurrent validity was measured by comparing the responses to the KOS-ADLS scores against the scores obtained from Visual Analogue Scale (VAS) and Global Rating Scale (GRS). Reliability was found satisfactory (ICC = 0.97; SEM = 3.03; SDD = 23.05; Cronbach's alpha = 0.98). Moreover, a gender subgroup analysis showed that women were more reliable than men. Minor floor/ceiling effects were detected. Concerning validity, all correlations were statistically significant, ranging from r = 0.315 to r = 0.741, however GRS presented higher correlations with KOS-ADLS in comparison with VAS. Finally, Greek KOS-ADLS was able to detect changes over time (standardized effect size = 1.31 and standardized response mean = 1.64). The Greek version of KOS-ADLS was found to be reliable, valid, responsive and comprehensible to use with patients with knee pathology.     

The Empathy Quotient: A cross-cultural comparison of the Italian version

Introduction. The Empathy Quotient (EQ) is a self-report questionnaire that was developed to measure the cognitive, affective, and behavioural aspects of empathy. We evaluated its cross-cultural validity in an Italian sample.

Methods. A sample of 18- to 30-year-old undergraduate students of both sexes (N=256, males=118) were invited to fill in the Italian version of the EQ, as well as other measures of emotional competence and psychological distress.

Results. The EQ had an excellent reliability (Cronbach's alpha=.79; test–retest at 1 month: Pearson's r=.85), and was normally distributed. Females scored higher than males, and more males (n=14, 11.9%) than females (n=4, 2.9%) scored lower than 30, the cutoff score that best differentiates autism spectrum conditions from controls. EQ was negatively related to the Toronto Alexithymia Scale (TAS) and positively related to the Marlowe-Crowne Social Desirability Scale (SDS). Principal component analysis retrieved the three-factor structure of the EQ. Lower emotional reactivity correlated with higher scores in measures of risk in both the schizophrenia-like (Peters et al. Delusions Inventory) and the bipolar (Hypomanic Personality Scale) spectra.

Conclusions. The Italian version of the EQ has good validity, with an acceptable replication of the original three-factor solution, yielding three subscales with high internal and test–retest reliability.     

Reliability and Concurrent Validity of Select C3 Logix Test Components

We sought to investigate the one-week and within-session reliability of the instrumented balance error scoring system test and the concurrent validity/one-week reliability of two neurocognitive assessments available through C3 Logix. (n = 37) Participants completed two balance error scoring system tests separated by the Trails A, Trails B, and Symbol Digit Modality test available through C3 Logix, and with paper and pencil. We found that the instrumented balance error scoring system test demonstrated strong one-week reliability and that neuropsychological tests available through C3 Logix show acceptable concurrent validity with standard (comparable) paper and pencil measures.     

老年人膝关节和踝关节位置觉的重测信度

背景：目前国内外关节位置觉的研究主要以青年人为对象,而老年人在不同角度关节位置重现的重测信度研究比较缺乏。 目的：观察老年人膝关节和踝关节在不同角度关节复位测试的重测信度。 方法：在Biodex system 3等速系统上用被动复位测试法测试28名健康老年人的膝、踝关节本体感觉,以被动复位绝对误差角度作为个体位置觉能力优劣的代表。重测信度评价指标为组内相关系数(ICC)。 结果与结论：左右两侧膝关节位置觉测试在不同角度都具有良好的重测信度,ICC值为0.851~0.973;左右两侧踝关节位置觉测试在跖屈与背伸位具有中等以上的重测信度,ICC值为0.742~0.964;左侧踝关节复位的绝对误差角度小于右侧踝关节(P < 0.05),且左侧(ICC为0.870~0.964)踝关节重测的相关系数高于右侧(ICC为0.742~0.944)。提示老年人膝关节和踝关节位置觉重测的相关性良好,并且左侧踝关节的相关性高于右侧。     

Validation of the Fitbit One,Garmin Vivofit and Jawbone UP activity tracker in estimation of energy expenditure during treadmill walking and running

Objectives: To determine the validity of energy expenditure estimation made by the Fitbit One, Garmin Vivofit and Jawbone UP activity trackers during treadmill walking and running. Determining validity of such trackers will inform the interpretation of the data they generate.

Design: Cross-sectional study.

Method: Fourteen adults walked at 0.70, 1.25, 1.80?ms^?1 and ran at 2.22, 2.78, 3.33?ms^?1 on a treadmill wearing a Fitbit One, Garmin Vivofit and Jawbone UP. Estimation of energy expenditure from each tracker was compared to measurement from indirect calorimetry (criterion). Paired t-tests, correlation coefficients and Bland–Altman plots assessed agreement and proportional bias. Mean percentage difference assessed magnitude of difference between estimated and criterion energy expenditure for each speed.

Results: Energy expenditure estimates from the Fitbit One and Garmin Vivofit correlated significantly (pr=?0.702; 0.854) with criterion across all gait speeds (0.70–3.33?ms^?1). Fitbit One, Garmin Vivofit and Jawbone UP correlated significantly (p?r?=?0.729; 0.711; 0.591) with criterion across all walking speeds (0.70–1.80?ms^?1). However, only the Garmin Vivofit correlated significantly (pr?=?0.346) with energy expenditure estimations from criterion across running speeds (2.22–3.33?ms^?1). Bland–Altman plots showed proportional bias for the Fitbit One and Garmin Vivofit. Energy expenditure estimations of single speeds were overestimated by the Fitbit One and underestimated by the Garmin Vivofit.

Conclusions: Energy expenditure reported by the devices distinguished between walking and running, with a general increase as exercise intensity increased. However, the reported energy expenditure from these devices should be interpreted with caution, given their potential bias and error.

• Practical implications

• Although devices report the same outcome of EE estimation, they are not equivalent to each other and differ from criterion measurements during walking and running.

• These devices are not suitable as research measurement tools for recording precise and accurate EE estimates but may be suitable for use in interventions of behaviour change as they provide feedback to user on trends in energy expenditure.

• If intending to use these devices in studies where precise measurements of energy expenditure are required, researchers need to undertake specific validation and reliability studies prior to interventions and the collection of cross-sectional data.

     

Monitoring Medication Adherence by Unannounced Pill Counts Conducted by Telephone: Reliability and Criterion-Related Validity

Abstract

Background: Although demonstrated valid for monitoring medication adherence, unannounced pill counts conducted in patients’ homes are costly and logistically challenging. Telephone-based unannounced pill counts offer a promising adaptation that resolves most of the limitations of home-based pill counting. Purpose: We tested the reliability and criterion-related validity of a telephone-based unannounced pill count assessment of antiretroviral adherence. Method: HIV-positive men and women (N = 89) in Atlanta, Georgia, completed a telephone-based unannounced pill count and provided contemporaneous blood specimens to obtain viral loads; 68 participants also received an immediate second pill count conducted during an unannounced home visit. Results: A high degree of concordance was observed between the number of pills counted on the telephone and in the home (intraclass correlation [ICC] = .981, p < .001) and percent of pills taken (ICC = .987, p < .001). Adherence obtained by the telephone count and home count reached 92% agreement (Kappa coefficient = .94). Adherence determined by telephone-based pill counts also corresponded with patient viral load, providing evidence for criterion-related validity. Conclusion: Unannounced telephone-based pill counts offer a feasible objective method for monitoring medication adherence.     

The scale of perceived interpersonal closeness (PICS)

The development and piloting of a new scale entitled the Perceived Interpersonal Closeness Scale (PICS) is described. The format of the PICS requires an individual to position other individuals within a circular ‘closeness’ space in which the distance between these others can be mapped as an ordinal distance rating. By removing the reliance on verbal ratings, the PICS is designed to be easily understood by respondents. The PICS is specifically designed to measure individual perception of interpersonal (socio‐emotional) closeness and captures both the individual's actual and ideal sense of perceived closeness and social support. The results illustrate that the scale has satisfactory psychometric properties, including short‐term test–retest reliability (median value r_s = 0.77), and acceptable face, concurrent and discriminant validity. It is proposed that this instrument is a pan‐theoretical and psychometrically sound assessment tool that can be clinically useful, regardless of therapeutic orientation. Copyright © 2003 John Wiley & Sons, Ltd.     

Reliability and validity of a single-item rating scale to monitor medication adherence for people living with HIV and lower health literacy

Background:

Monitoring medication adherence in clinical and research settings may be especially challenging for people with lower literacy skills.

Objective:

The current study examined the measurement properties of a single-item rating scale (SIRS) for assessing medication adherence in a sample of 468 people living with HIV and lower health literacy skills.

Methods:

Participants completed two versions (computerized and telephone interview) of an SIRS as well as unannounced monthly pill counts. We also collected measures of common correlates of adherence and obtained participants' HIV RNA viral load from medical records.

Results:

Results indicated that the SIRS is time stable over one month (r?=?0.46 to 0.52). There was limited evidence for modality effects between the computerized and phone administered SIRS. Associations with unannounced pill counts demonstrated concurrent and predictive validity of the SIRS, and criterion-related validity by associations with viral load. However, the SIRS also demonstrated inflated adherence estimates relative to unannounced pill counts and these discrepancies were greatest for persons of lower income and who reported alcohol use.

Conclusions:

A simple SIRS to monitor medication adherence may therefore be reliable and valid for use with people challenged by lower literacy skills in both clinical and research settings.     

Body composition in urban South Asian women; development of a bioelectrical impedance analysis prediction equation

Abstract

Background: Assessment of body composition plays a significant role in combating chronic disease among South Asians. Accurate assessment of body composition by bioelectrical impedance analysis (BIA) requires population-specific equations which are currently unavailable for urban South Asian women.

Aim: To assess validity of direct BIA assessment and selected equations for prediction of total body water (TBW), against Deuterium (²H₂O) dilution and develop and validate a population-specific TBW equation for urban South Asian women.

Subjects and method: Data of 80 urban Sri Lankan women (30–45 years) were used for this analysis. Body composition was assessed by ²H₂O dilution (reference) and BIA. Available BIA equations were assessed for validity. A new TBW equation was generated and validated.

Results: Direct BIA measurements and other equations did not meet validation criteria in predicting TBW. TBW by the new equation (TBW?=?3.443?+?0.342?×?(height²/impedance)?+?0.176?×?weight) correlated (p?<?0.001) with TBW by reference method. TBW using the new equation was not significantly different (25.30?±?2.4?kg) from the reference (25.32?±?2.7?kg).

Conclusion: Direct use of TBW by instrument and existing equations are less suitable for this population. The new TBW equation is suitable for body composition assessment in urban South Asian women.     

Validity and reliability of the Horiba C-122 compact sodium analyzer in sweat samples of athletes

Accurate sodium replacement during prolonged exercise is possible when sweat rate and sweat sodium content are directly measured. Few athletes have access to sweat sodium content measurement, as the equipment needed to perform such analyzes is costly, laboratory-based or requires technical skills. Using 70 sweat samples collected in 24 athletes from 3 anatomical sites, this study determined the reliability [single-trial and inter-day (7 samples over 3?days)] and validity (instrument error) of a pocket-sized, easy-to-use and low cost sodium analyzer (Horiba C-122, Kyoto, Japan) against reference values of an ion chromatograph, the 883 Basic IC plus (Metrohm AG, Herisau, Switzerland). The Horiba C-122 showed high single-trial reliability with an intraclass correlation coefficient (ICC) of 0.997, a typical error of measurement (EM) of 1.77?mmol/L and a coefficient of variation (CV) of 3.73%. As expected, the reliability of the 883 Basic IC plus was superior to that of the Horiba C-122 (ICC: 0.999; typical EM: 0.70?mmol/L; CV: 1.52%). The Horiba’s C-122 inter-day reliability was high (ICC: 1.00; typical EM: 0.35?mmol/L). An ICC of 0.975 indicates there was a strong relationship between results provided by both analyzers. Compared with reference values, the Horiba C-122 demonstrated a mean bias of 1.71?mmol/L, a pure EM of 7.52?mmol/L and 68% limits of agreement ranging from ?5.81 to 9.23?mmol/L. We propose that the Horiba C-122 is sufficiently reliable to be used under field conditions where some degree of imprecision is acceptable, but not for research purposes where high accuracy is required.     

Instrument measurement of lingual force variability reflects tardive tongue dyskinesia

Tardive tongue dyskinesia is often under-diagnosed or misdiagnosed. Instrument measurement of lingual force variability may be a valid and reliable method for assessing tardive tongue dyskinesia. Instrument measurement of lingual force variability was compared to the clinical level of tardive tongue dyskinesia and total body dyskinesia as measured by the Abnormal Involuntary Movement Scale (AIMS) in 35 subjects: 23 patients with a psychiatric disorder using antipsychotics, of which 11 were with and 12 were without tardive tongue dyskinesia, and 12 age- and gender-matched healthy controls. Lingual force variability correlated with tardive tongue dyskinesia (Spearman r?=?0.56; p?<?0.01) and with total dyskinesia (r?=?0.47; p?=?0.02); there was no association with age, antipsychotic dose, or psychiatric diagnosis. Instrument test-retest reliability corresponded with an ICC of 0.85 p?<?0.0001. Instrument measurement of lingual force variability is a valid and reliable method for assessing tardive tongue dyskinesia.     

Comparison between body mass index and a body shape index with adiponectin/leptin ratio and markers of glucose metabolism among adolescents

Background: Besides body mass index (BMI), new parameters have been developed to classify individual body shape.

Aim: To investigate the relationship between BMI, waist circumference (WC), a body shape index (ABSI) and ABSI-adolescents among adolescents and verify which would better predict lower adiponectin/leptin (A/L) ratio and disturbances on glucose metabolism.

Subjects and methods: A cross-sectional study with 197 Brazilian adolescents of 14–18?years. Serum leptin, adiponectin, glucose and insulin were measured. A/L ratio, ABSI, ABSI-adolescents, BMI, homeostasis model assessment estimates of insulin resistance (HOMA-IR) and β-cell function (HOMA-β) and the quantitative insulin sensitivity check index (QUICKI) were calculated.

Results: ABSI-adolescents positively correlated with WC (r?=?0.83, p?r?=?0.66, p?r?=?0.95, p?p?r?=??0.63, p?p?r?=??0.75; HOMA-IR: r?=?0.76; HOMA-β: r?=?0.77; insulin: r?=?0.79). Associations were confirmed by linear regression analysis, adjusted for sex and age.

Conclusions: ABSI-adolescents, but not ABSI, was related to A/L ratio and to markers of glucose metabolism, but not more strongly than BMI and WC.     

The Reliability of Arousal Threshold During Sleep

Thirty-five subjects from two independent studies were awakened at EEG-defined periods during the night with 1000 Hz ascending tone series. Awakenings were made five to eight times per night during stage 2, stage 4, or REM sleep over a series of nights in good and poor sleepers. Reliability was assessed within stage, within night, between stages, and between nights. Good and poor sleepers did not differ in either depth of sleep or reliability of arousal threshold and were thus pooled in the analyses. From night to night, the most consistency was seen in stage 4 (r=.74), although REM reliability (r?₁= .49) and stage 2 reliability (r?₁= .50 and r?₁= .69 in the two respective studies) estimates were also greater than zero. Early sleep onset and morning arousals were more variable. Reliability estimates on arousal thresholds taken within the same night for stage 2 were r= .64 and r?₁= .77 for the two studies and r= .96 for REM. The depth of sleep was not correlated with awake auditory threshold. It was concluded that five or six carefully placed arousals could give a good estimate of an individual's usual arousal threshold.     

Test�Cretest reliability of the nociceptive withdrawal reflex and electrical pain thresholds after single and repeated stimulation in patients with chronic low back pain

Recent studies have shown that the nociceptive withdrawal reflex threshold (NWR-T) and the electrical pain threshold (EP-T) are reliable measures in pain-free populations. However, it is necessary to investigate the reliability of these measures in patients with chronic pain in order to translate these techniques from laboratory to clinic. The aims of this study were to determine the test?Cretest reliability of the NWR-T and EP-T after single and repeated (temporal summation) electrical stimulation in a group of patients with chronic low back pain, and to investigate the association between the NWR-T and the EP-T. To this end, 25 patients with chronic pain participated in three identical sessions, separated by 1?week in average, in which the NWR-T and the EP-T to single and repeated stimulation were measured. Test?Cretest reliability was assessed using intra-class correlation coefficient (ICC), coefficient of variation (CV), and Bland?CAltman analysis. The association between the thresholds was assessed using the coefficient of determination (r ²). The results showed good-to-excellent reliability for both NWR-T and EP-T in all cases, with average ICC values ranging 0.76?C0.90 and average CV values ranging 12.0?C17.7%. The association between thresholds was better after repeated stimulation than after single stimulation, with average r ² values of 0.83 and 0.56, respectively. In conclusion, the NWR-T and the EP-T are reliable assessment tools for assessing the sensitivity of spinal nociceptive pathways in patients with chronic pain.     

Development and validation of a new figural drawing scale for body‐image assessment: the BIAS‐BD

This study describes the development and validation of a new and improved body‐image assessment tool, the BIAS‐BD, based on known body dimensions. The scale's construction consisted of 17 male and 17 female contour‐line drawings that used known anthropometric body dimensions of shoulder, chest, waist, hip breadth, thigh breadth, and upper leg breadth. The figural drawings correspond to a series of body weights ranging from 60% below the known average to 140% above average. Differences between figural drawings represented a 5% change in body weight. Participants were 207 undergraduates, including 66 men and 141 women, who selected drawings that reflected their perceived size and their ideal size. Retesting occurred after a 2‐week interval and resulted in test–retest reliability values of r=.86 for actual perceived size, r=.72 for ideal size, and r=.76 for body dissatisfaction (p<.005). There were no significant differences in reliability values between genders. Mean differences in perceived size, ideal size, and body dissatisfaction between the two test administrations were small. Concurrent validity, measured as the correspondence between perceived and reported size, was r=.76 (p<.005). Participants slightly overestimated their perceived body size, with women overestimating significantly more. Unlike existing scales, the present scale uses figural drawings based on known body dimensions and has better reliability and validity. It avoids several problems inherent in existing scales, including scale coarseness, the presence of ethnic facial and body features, and the lack of documented reliability and validity values. © 2008 Wiley Periodicals, Inc. J Clin Psychol 65:113–122, 2009.     

Reliability of Doppler and stethoscope methods of determining systolic blood pressures: considerations for calculating an ankle-brachial index

PurposeThe purposes of this study were to: (1) identify the interrater and intrarater reliability of systolic blood pressures using a stethoscope and Doppler to determine an ante brachial index (ABI), and (2) to determine the correlation between the 2 methods.BackgroundPeripheral arterial disease (PAD) affects approximately 8 to 12 million people in the United States, and nearly half of those with this disease are asymptomatic. Early detection and prompt treatment of PAD will improve health outcomes. It is important that clinicians perform tests that determine the presence of PAD.MethodTwo individual raters trained in ABI procedure measured the systolic blood pressures of 20 individuals' upper and lower extremities. Standard ABI measurement protocols were observed. Raters individually recorded the systolic blood pressures of each extremity using a stethoscope and a Doppler, for a total of 640 independent measures.ResultsInterrater reliability of Doppler measurements to determine SBP at the ankle was very strong (intraclass correlation coefficient [ICC], 0.93-0.99) compared to moderate to strong reliability using a stethoscope (ICC, 0.64-0.87). Agreement between the 2 devices to determine SBP was moderate to very weak (ICC, 0.13-0.61). Comparisons of the use of Doppler and stethoscope to determine ABI showed weak to very weak intrarater correlation (ICC, 0.17-0.35). Linear regression analysis of the 2 methods to determine ABI showed positive but weak to very weak correlations (r² = .013, P = .184).ConclusionsA Doppler ultrasound is recommended over a stethoscope for accuracy in systolic pressure readings for ABI measurements.