BVE provided more accurate and reliable PAD screening than ABI across diverse patient populations, including those with comorbidities that reduce ABI accuracy, supporting its use as a first-line screening tool particularly in rural and underserved settings.
Key Findings
Results
BlueDop Vascular Expert (BVE) demonstrated higher overall sensitivity, specificity, and accuracy than ABI for detecting PAD in the combined dataset.
Combined dataset included 751 limbs assessed by BVE (550 from current cohort, 201 from previously published dataset by Tessendorf et al.)
BVE overall sensitivity was 82.5%, specificity was 93.9%, accuracy was 91.2%, and κ=0.76
ABI sensitivity was 58.3%, specificity was 87.4%, accuracy was 80.6%, and κ=0.46
Full leg arterial duplex interpreted by an independent vascular surgeon served as the reference standard
Results
BVE outperformed ABI across all analysed subgroups of patients with comorbidities including diabetes, hypertension, tobacco use, and obesity.
Increased accuracy, sensitivity, specificity, and κ constant were present in all analysed subgroups when comparing BVE to ABI
Subgroup analysis specifically compared BVE and ABI capabilities among those with diabetes, hypertension, tobacco use, and obesity
These comorbidities were selected because they are known to affect PAD detection accuracy
The study population was described as diverse and included individuals with histories of smoking, obesity, diabetes, and hypertension
Methods
The study used a prospective design combining data from a new single-centre cohort and a previously published dataset.
Data from two separate studies were used: a current single-centre cohort (n=550 limbs) and a previously published dataset by Tessendorf et al. (n=201 limbs)
Data from the current cohort was analysed independently and in combination with the Tessendorf et al. study
Individuals at risk for PAD underwent both ABI and BVE testing
The combined total was 751 limbs assessed by BVE
Discussion
BVE's portability, ease of use, and minimal need for specialised interpretation support its deployment as a first-line PAD screening tool in rural and underserved settings.
The authors highlight BVE's portability and ease of use as key practical advantages over ABI
Minimal need for specialised interpretation was identified as a feature supporting broader access
The authors state broader implementation of BVE 'could help reduce diagnostic disparities and improve outcomes for patients at risk for PAD'
Rural and underserved settings were specifically identified as target environments for BVE deployment
Results
ABI demonstrated substantially lower sensitivity compared to BVE, suggesting it may miss a significant proportion of PAD cases.
ABI sensitivity was 58.3% compared to BVE sensitivity of 82.5%, a difference of 24.2 percentage points
ABI κ=0.46 compared to BVE κ=0.76, indicating substantially lower agreement with the reference standard
ABI accuracy was 80.6% compared to BVE accuracy of 91.2%
Comorbidities such as diabetes, hypertension, tobacco use, and obesity are noted to reduce ABI accuracy
What This Means
This research suggests that a device called BlueDop Vascular Expert (BVE) is significantly better at detecting peripheral arterial disease (PAD) — a condition where arteries in the legs become narrowed or blocked — compared to the standard screening test called the ankle-brachial index (ABI). The study tested both tools on 751 legs from patients at risk for PAD and checked the results against detailed ultrasound scans read by vascular surgeons. BVE correctly identified PAD about 83% of the time (sensitivity), while ABI only caught about 58% of cases, meaning ABI missed roughly one in four PAD patients that BVE would have caught.
The advantage of BVE was consistent across patients with conditions that are known to make PAD harder to diagnose, including diabetes, high blood pressure, smoking, and obesity. These conditions can make ABI results unreliable, but BVE continued to outperform ABI in every one of these patient subgroups. This is particularly important because these are precisely the patients most likely to have PAD and most likely to be harmed by a missed diagnosis.
This research suggests that BVE could be especially valuable in rural areas and underserved communities where vascular specialists are scarce, because it is portable, easy to use, and does not require expert interpretation. Wider use of this tool could potentially help reduce gaps in care for patients who currently have limited access to vascular disease screening and diagnosis.
Bockern B, Woldt M, Devine J, Withrow A, Tessendorf C, Bleeker C, et al.. (2026). Expanding access to vascular care using BlueDop Vascular Expert: an artificial intelligence-driven diagnostic tool.. Journal of wound care. https://doi.org/10.12968/jowc.2025.0595