Evidence map›Paper›PMID 40481261›Full record

Observational studyCardiovascular intervention and therapeutics2025

Doppler extremity arterial diagnosis for optimization of treatment in the emergency department (DEAD FOOT).

Jesse M Schafer, Brian Q Gacioch, Tyler Beals, Daniel S Balk, Stephen H Thomas, Beatrice Hoffmann

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Cardiovascular intervention and therapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jesse M SchaferDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA. jmschafe@bidmc.harvard.edu.ORCID http://orcid.org/0000-0003-1738-7777
Brian Q GaciochDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.
Tyler BealsDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.
Daniel S BalkDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.
Stephen H Thomas *Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.
Beatrice Hoffmann *Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Outcomes in acute limb ischemia (ALI) depend on early recognition. Rapid evaluation methods in the emergency department (ED) include physical exam, hand-held Doppler (HH), or spectral Doppler (SD) using point-of-care ultrasound (POCUS). This study aims to estimate performance characteristics of HH versus emergency medicine (EM)-performed SD compared to angiography along with clinician confidence when evaluating for ALI. This was a prospective observational pilot study. A convenience sample of patients presenting to an urban, academic ED with concern for ALI who underwent angiography were eligible. The primary aim evaluated diagnostic performance of HH and SD in correctly classifying flow in posterior tibial (PT) and dorsalis pedis (DP) arteries in patients with 100% angiographic occlusion of the proximal vasculature. Binomial exact 95% confidence intervals (CIs) and Fisher's exact tests were used. Twenty-six patients were enrolled. Three cases (11.5% of 26) had normal angiography, five (19.2%) had partial occlusion, and 18 (69.2%) had 100% occlusion. For cases with 100% occlusion, HH always classified PT or DP as abnormal (sensitivity 100, 95% CI 81.5-100%). SD also showed high sensitivity (94.4, 95% CI 72.7-99.9%). Limited utility of specificity calculations was due to low true negatives (n = 3), but these measures were low for HH (66.7, 95% CI 9.4-99.2%) and SD (33.3, 95% CI 0.8-90.6%). There was no association (p = .305) between sonographer confidence and correct diagnostic classification for either HH or SD. In a patient population with suspected ALI, EM-performed HH and SD performed extremely well at identifying abnormal PT or DP flow in patients with complete (100%) angiographic occlusion. These results are useful to power larger trials to determine the role that SD may play in complementing HH evaluation for ALI.

Indexed as

Emergency Service, HospitalIschemiaUltrasonography, DopplerAgedAngiographyFemaleHumansMaleMiddle AgedPilot ProjectsProspective StudiesAcute limb ischemiaEmergency medicinePoint-of-care ultrasoundSpectral Doppler

Identifiers

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.