Choosing a practical screening instrument to identify patients at risk for diabetic foot ulceration.
To evaluate the sensitivity and specificity of 3 sensory perception testing instruments to screen for risk of diabetic foot ulceration.
This case-control study prospectively measured the degree of peripheral sensory neuropathy in diabetic patients with and without foot ulcers.
We enrolled 115 age-matched diabetic patients (40% male) with a case-control ratio of approximately 1 : 3 (30 cases and 85 controls) from a tertiary care diabetic foot specialty clinic.
Cases were defined as individuals who had an existing foot ulceration or a history of a recently (<4 weeks) healed foot ulceration.
Controls were defined as subjects with no foot ulceration history.
Using receiver operating characteristic analysis, we evaluated the sensitivity and specificity of 2 commonly used neuropathy assessment tools (vibration perception threshold testing and the Semmes-Weinstein 10-g monofilament wire system) and a 4-question verbal neuropathy score to evaluate for presence of foot ulceration.
A vibration perception threshold test using 25 V and lack of perception at 4 or more sites using the Semmes-Weinstein 10-g monofilament wire system had a significantly higher specificity than the neuropathy score used.
The neuropathy score was most sensitive when 1 or more answers were affirmative. (...)
Mots-clés Pascal : Diabète, Complication, Ulcération, Pied, Membre inférieur, Risque, Dépistage, Neuropathie périphérique, Technique, Evaluation performance, Homme, Endocrinopathie, Trouble trophique, Peau pathologie, Système nerveux pathologie, Nerf périphérique pathologie
Mots-clés Pascal anglais : Diabetes mellitus, Complication, Ulceration, Foot, Lower limb, Risk, Medical screening, Peripheral neuropathy, Technique, Performance evaluation, Human, Endocrinopathy, Trophic lesion, Skin disease, Nervous system diseases, Peripheral nerve disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0135508
Code Inist : 002B21E01B. Création : 21/07/1998.