eZyABI: Portable Automatic Ankle-Brachial Index Screening for Field and Ambulatory Vascular Assessment
Closing the Gap Between Guideline Recommendation and Clinical Reality
Ankle-Brachial Index (ABI) measurement is a Grade A recommendation in multiple international diabetes management guidelines for the detection of peripheral arterial disease (PAD). However, implementation of routine ABI screening in primary care, district hospitals, and outreach diabetes camps remains limited — primarily due to the complexity, cost, and space requirements of traditional vascular laboratory equipment. The result is a persistent diagnostic gap that allows PAD to progress undetected in high-risk diabetic populations, often until limb-threatening sequelae have already developed.
eZyABI, developed by Diabetik Foot Care India Pvt Ltd, Chennai, is a compact ABI measurement device designed to address this implementation gap by delivering accurate vascular screening capability in a portable, operator-friendly format.
Device Architecture and Operating Principle
eZyABI is based on oscillometric blood pressure measurement technology integrated into a lightweight unit. The device measures systolic, diastolic, mean arterial pressures at ankle and brachial sites using standard blood pressure cuffs, automatically calculates the resting ABI for each limb, and displays the result on a clear digital interface within minutes of cuff application. Suggests an exercise ABI whenever the resting ABI falls under borderline.
The operating design prioritises simplicity without compromising clinical validity:
• Bilateral ABI calculation from sequentially acquired limb pressures
• Automatic inflation, measurement, and deflation cycle — no manual Doppler probe required
• Within 3-4 minutes the measurement of all the four limbs completed
• Digital ABI readout with interpretive flag (Normal / Borderline / Abnormal)
• Minimal calibration requirement — factory pre-calibrated with periodic verification recommended
Clinical Validation and Accuracy
eZyABI's oscillometric ABI values have been validated against Doppler-based reference standards. While oscillometric ABI measurements have a well-documented tendency to over-estimate systolic pressures at the ankle compared to continuous-wave Doppler techniques — a characteristic shared across oscillometric ABI devices in the literature — the clinical sensitivity and specificity of oscillometric ABI for identifying ABI values below 0.9 (the standard diagnostic threshold for PAD) are sufficient for screening purposes in the primary care and outreach context.
Deployment Scenarios
eZyABI is particularly suited to the following clinical deployment contexts:
• Rural and semi-urban primary health centres managing diabetic patient populations
• Diabetic screening camps and community health outreach programmes
• General physician clinics conducting annual diabetic complication reviews
• Pre-discharge vascular risk assessment in general medicine wards
• District hospitals where a full vascular laboratory is not operationally feasible
In each of these settings, eZyABI enables clinical teams to perform a guideline-compliant vascular screening assessment without referral to a tertiary vascular centre — thereby accelerating the identification of high-risk individuals who require further evaluation or specialist intervention.
Documentation and Referral Support
Each eZyABI measurement generates a structured result record including bilateral ABI values, measurement date and time, and an interpretive classification. These records support documentation of diabetic complication screening in patient records and facilitate evidence-based referral letters for vascular surgery or cardiology review.
For institutions maintaining electronic diabetic registers or implementing National Diabetes Prevention Programme (NDPP) documentation frameworks, eZyABI results can be manually entered into EMR systems, with future connectivity options under development.
Summary
eZyABI brings evidence-based peripheral vascular screening within reach of clinical teams operating beyond the boundaries of the tertiary vascular laboratory. Its portability, ease of use, and clinical validity make it a practical instrument for implementing ABI screening at scale — closing the diagnostic gap that currently allows PAD to progress silently in vulnerable diabetic populations.
