Background: Ankle-brachial index (ABI) at rest is the main clinical tool to diagnose the presence of lower extremity peripheral artery disease (PAD). The method for ABI procedure (i.e., measurement, calculation and interpretation) is standardised and guidelines were published in 2012. This study sought to: i) assess knowledge about the three major steps of the ABI procedure (i.e., measurement, calculation and interpretation) among residents from different medical schools, ii) compare the ABI knowledge of experienced residents (i.e., who have already performed ABI procedure more than 20 times) with the knowledge of inexperienced residents, and iii) describe the most common errors by residents. Methods: Residents from six medical schools were invited to complete a questionnaire about the ABI procedure. Results: Sixty-eight residents completed the questionnaire. None of them knew how to perform the entire ABI procedure. Overall, 22 %, 13 % and 41 % of residents correctly answered questions about ABI measurement, ABI calculation and ABI interpretation, respectively. Score comparisons underlined the fact that experienced residents (n = 26) answered ABI measurement questions to a significantly better level and had a significantly higher total score than inexperienced residents (n = 42) (P = 0.0485 and P = 0.0332, respectively). Errors were similar for most of the residents. Conclusions: Our study confirms that experienced residents have significantly better ABI procedure knowledge than inexperienced residents. However, none of them are able to perform the entire ABI procedure without any mistake with regard to current guidelines. It is important that training be given to residents in medical schools in order to improve their ABI procedure knowledge.

Purpose: This study aimed to determine and compare the accuracy of different activity monitors in assessing intermittent outdoor walking in both healthy and clinical populations through the development and validation of processing methodologies. Methods: In study 1, an automated algorithm was implemented and tested for the detection of short (≤1 min) walking and stopping bouts during prescribed walking protocols performed by healthy subjects in environments with low and high levels of obstruction. The following parameters obtained from activity monitors were tested, with different recording epochs^{0.1s/0.033s/1s/3s/10s} and wearing locations^{scapula/hip/wrist/ankle}: GlobalSat DG100 (GS) and Qstarz BT-Q1000XT/-Q1000eX (QS) speed; ActiGraph wGT3X+ (AG) vector magnitude (VM) raw data, VM counts, and steps; and StepWatch3 (SW) steps. Furthermore, linear mixed models were developed to estimate walking speeds and distances from the monitors parameters. Study 2 validated the performance of the activity monitors and processing methodologies in a clinical population showing profile of intermittent walking due to functional limitations during outdoor walking sessions. Results: In study 1, GS^{1s, scapula}, QS^{1s, scapula/wrist} speed, and AG^{0.033s, hip} VM raw data provided the highest bout detection rates (>96.7%) and the lowest root mean square errors in speed (≤0.4 km·h⁻¹) and distance (<18 m) estimation. Using SW^{3s, ankle} steps, the root mean square error for walking/stopping duration estimation reached 13.6 min using proprietary software and 0.98 min using our algorithm (total recording duration, 282 min). In study 2, using AG^{0.033s, hip} VM raw data, the bout detection rate (95% confidence interval) reached 100% (99%–100%), and the mean (SD) absolute percentage errors in speed and distance estimation were 9% (6.6%) and 12.5% (7.9%), respectively. Conclusions: GPS receivers and AG demonstrated high performance in assessing intermittent outdoor walking in both healthy and clinical populations.

International audienceWe read with interest the opposite viewpoints of McDermott et al1 and Hiatt et al2 about the best functional test for measuring response to interventions in peripheral artery disease (PAD). Community-based global positioning system (GPS) measurement has been recently proposed to assess outdoor walking capacity in PAD patients, that is, under conditions expected to be closer to real life.3–5 Although an emerging approach, GPS assessment provides some interesting insights, adding arguments to the aforementioned controversies