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The United States Preventive Services Task Force (USPSTF) found insufficient evidence to recommend for or against using the ankle-brachial index (ABI) as a screening test for peripheral artery disease (PAD) in asymptomatic adults. PAD is a common circulatory problem in which narrowed arteries reduce blood flow to the limbs. In addition to morbidity directly caused by PAD, patients have an increased risk for cardiovascular disease (CVD) events. Screening asymptomatic patients could reduce patient morbidity and mortality by identifying patients who are at hidden risk for CVD. The ABI is the ratio of the ankle and brachial systolic blood pressure that has been used as a marker for PAD. In 2005, the Task Force recommended against using ABI as a screening test for PAD because there was little evidence that screening would improve outcomes any more than treatment based on standard CVD risk assessment. To inform the update, researchers assessed new evidence on the ability of the ABI to predict cardiovascular disease morbidity and mortality independent of the Framingham Risk Score (FRS) in asymptomatic adults. They also assessed the benefits and harms of treating adults found to have PAD through screening. The researchers found insufficient evidence to assess the balance of benefits and harms of screening for PAD and CVD risk assessment with ABI. They also found insufficient evidence to establish the benefits of treating screening-detected PAD in asymptomatic individuals.
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