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January 16, 2002

Diagnosis and Treatment of Peripheral Arterial Disease—Reply

Author Affiliations

Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2002

JAMA. 2002;287(3):313-316. doi:10.1001/jama.287.3.313

In Reply: The article by Dr Hirsch and colleagues1 suggested that the measurement of Doppler-derived ABI yields useful diagnostic data that allows the primary care physician to better identify patients with lower extremity occlusive disease and, more importantly, generalized atherosclerosis. Dr Jimbo and Dr Fried challenge this premise, questioning whether the ABI really adds diagnostic power to that of clinical variables alone. They raise valid issues with respect to the actual percentage of patients whose diagnosis would be missed without the use of the ABI; most patients with PAD have other comorbidities such as diabetes and hyperlipidemia that help the physician identify and treat atherosclerotic cardiovascular disease.

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