Herraiz-Adillo A, Cavero-Redondo I, Álvarez-Bueno C, et al. - The diagnostic accuracy of ankle brachial index (ABI) was compared with that of toe brachial index (TBI) for peripheral arterial disease (PAD) in a wide spectrum of PAD populations and reference standard tests. In addition, variables influencing heterogeneity in the estimates were determined. Performing systematic searches in EMBASE, MEDLINE, Web of Science and the Cochrane Library databases, they identified 35 (patient-level: 1,318 patients, limb-level: 5,637 limbs) and nine studies (patient-level: 294 patients, limb-level: 826 limbs) for inclusion in ABI and TBI meta-analyses, respectively. Findings suggest similar diagnostic performance of ABI and TBI in diagnosing PAD, however, TBI vs ABI had far better sensitivity, especially in “challenging populations”, as those exhibiting calcification.