Woodbury MG, Sibbald RG, Ostrow B, Persaud R, Lowe JM, et al.
PloS one. Date of publication 2015 Jun 29;volume 10(6):e0125578.
1. PLoS One. 2015 Jun 29;10(6):e0125578. doi: 10.1371/journal.pone.0125578.
eCollection 2015.
Tool for Rapid & Easy Identification of High Risk Diabetic Foot: Validation &
Clinical Pilot of the Simplified 60 Second Diabetic Foot Screening Tool.
Woodbury MG(1), Sibbald RG(2), Ostrow B(2), Persaud R(3), Lowe JM(2).
Author information:
(1)Queen's University, Kingston, ON, Canada.
(2)University of Toronto, Toronto, ON, Canada.
(3)Suddie Hospital, Essequibo, Guyana.
BACKGROUND: Most diabetic foot amputations are caused by ulcers on the skin of
the foot i.e. diabetic foot ulcers. Early identification of patients at high risk
for diabetic foot ulcers is crucial. The 'Simplified 60-Second Diabetic Foot
Screening Tool' has been designed to rapidly detect high risk diabetic feet,
allowing for timely identification and referral of patients needing treatment.
This study aimed to determine the clinical performance and inter-rater
reliability of 'Simplified 60 Second Diabetic Foot Screening Tool' in order to
evaluate its applicability for routine screening.
METHODS AND FINDINGS: The tool was independently tested by n=12 assessors with
n=18 Guyanese patients with diabetes. Inter-rater reliability was assessed by
calculating Cronbach's alpha for each of the assessment items. A minimum value of
0.60 was considered acceptable. Reliability scores of the screening tool
assessment items were: 'monofilament test' 0.98; 'active ulcer' 0.97; 'previous
amputation' 0.97; 'previous ulcer' 0.97; 'fixed ankle' 0.91; 'deformity' 0.87;
'callus' 0.87; 'absent pulses' 0.87; 'fixed toe' 0.80; 'blisters' 0.77; 'ingrown
nail' 0.72; and 'fissures' 0.55. The item 'stiffness in the toe or ankle' was
removed as it was observed in only 1.3% of patients. The item 'fissures' was also
removed due to low inter-rater reliability. Clinical performance was assessed via
a pilot study utilizing the screening tool on n=1,266 patients in an acute care
setting in Georgetown, Guyana. In total, 48% of patients either had existing
diabetic foot ulcers or were found to be at high risk for developing ulcers.
CONCLUSIONS: Clinicians in low and middle income countries such as Guyana can use
the Simplified 60-Second Diabetic Screening Tool to facilitate early detection
and appropriate treatment of diabetic foot ulcers. Implementation of this
screening tool has the potential to decrease diabetes related disability and
mortality.
DOI: 10.1371/journal.pone.0125578
PMCID: PMC4486169
PMID: 26121258 [Indexed for MEDLINE]
