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

Objectives: 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). Participants and methods: 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. Results: 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). Conclusion: 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.