Measuring consistency: The reliability of pedal acceleration time measurements across and within raters

• Published in: Annals of vascular surgery. Brief reports and innovations Vol. 5; no. 3; p. 100400
• Main Authors: Hart, Odette, Allan, Philip, August, Bridget, Abbott, Grant, Evans, Catherine, Khashram, Manar
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.09.2025
• Subjects: Chronic limb threatening ischaemia; Inter-rater reliability; Intra-rater reliability; Pedal acceleration time; Peripheral arterial disease; Plantar acceleration time; Surgery; Peripheral arterial disease; Chronic limb threatening ischaemia; Inter-rater reliability; Pedal acceleration time; Intra-rater reliability; Plantar acceleration time
• ISSN: 2772-6878; 2772-6878
• DOI: 10.1016/j.avsurg.2025.100400

Pedal acceleration time (PAT) is a novel non-invasive lower limb perfusion assessment tool. However, the test-retest reliability between and within raters has not been examined. The aim of this pilot study was to assess the inter- and intra-rater reliability of PAT measurements. Ten patients with diabetic foot and/or chronic limb threatening ischaemia underwent three repeated PAT measurements across three pedal arteries in a single limb by three trained sonographers. Inter-rater reliability was assessed as the contribution to variance by patients, raters, and replicates. Intra-rater reliability was quantified by the within-subject coefficient of variation (CV). The effects of raters and repeat measures was summarised using the intraclass correlation coefficient (ICC). Inter-rater reliability showed little contribution to variance at only ≤0.4 %, with ≥88.1 % of variance being that driven by patient variability. Intra-rater reliability as assessed by CV ranged between 10.8 %-12.2 %. The combined effect of raters and repeat measures assessed by ICC was 0.88–0.99 (good-to-excellent reliability). This pilot study suggests PAT can be reliably measured by trained sonographers with good-to-excellent inter- and intra-rater reliability.