Usman is a Consultant Vascular Surgeon and Senior Lecturer at Imperial College NHS Trust. He has a passion for training and has published and lead on numerous high impact papers. Usman is now supervising PhD and MD students through post-graduate degrees. As a day job he practices the full spectrum of vascular procedures for his patients at Saint Mary’s Hospital and West Middlesex Hospitals.

He holds a post graduate certificate in medical education and is a full fellow of the Higher Education Academy. He has authored the ‘Manual of Vascular Ultrasound’ and developed a training simulator and assessment framework for Vascular waveform assessment for frontline clinical staff.

Usman’s Patient Empowerment work emanates from his development of ‘Communities of Practice’ for Patient Activation and Supported self management. The aim of this project is to ‘right shift’ Patient Activation leading to better outcomes for everyday people at a lower cost to Society.

Presentation at the WReN Scientific Meeting, Glasgow, May 2022

Peripheral arterial disease diagnostics in people with diabetes

Objectives

After attending this session, persons will be able to:

• Scope current point of care tests for detecting PAD in people with Diabetes
• Understand limitations of various tests
• Learn about waveform analysis
• Learn about principles of Duplex ultrasound
• Learn about PAD scan and application to detected PAD in people with Diabetes

Abstract

PAD is a major risk factor for diabetic foot ulceration and amputation. Its diagnosis is fundamental though challenging. Although a variety of bedside tests are available, there is no agreement as to which is the most useful. PAD-scan may be advantageous over current tests as it allows for vessel visualisation and more accurate arterial waveform assessment. However, its accuracy has not been previously evaluated.

Based on the reference test, 202 (66.2%) patients had evidence of PAD. PAD-scan had a significantly higher sensitivity (95%, CI 90 to 97%) as compared to all other tests. Particularly low sensitivities were seen with pulse palpation (43%, CI 36 to 50%) and TcPO2 (31%, CI 24 to 38%). PAD-scan had a lower specificity (77%, CI 67 to 84%) compared to TBPI (86%, CI 78 to 93%; p<0.001), but not statistically different when compared to all other tests.