DIAFORA Diabetic Foot Risk Assessment Tool

NewsBot · Feb 1, 2016

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A new diabetic foot risk assessment tool: DIAFORA
M. Monteiro-Soares MhD andM. Dinis-Ribeiro PhD
Diabetes/Metabolism Research and Reviews; Accepted Article

Aims
To derive a new model to classify subjects with diabetes and active diabetic foot ulcer (DFU) by their risk of lower extremity amputation (LEA).

Methods
A prospective cohort study was conducted that included all subjects with DFU attending our Hospital Diabetic Foot Clinic from 2010 to 2013. Variables were collected at baseline. Subjects were followed until healing, LEA, death or for at least 3 months. Logistic regression was used to derive the new model and the area under the receiver operating characteristic curve (AUC) was assessed to propose the model with the greatest discrimination.

Results
A total of 293 participants were included and followed for a median of 91 days. In 23.2% amputation was required, 5.1% died and 3.1% were lost. Our final model included the variables most commonly used in clinical practice for diabetic foot risk assessment (presence of neuropathy, foot deformity, peripheral arterial disease and previous foot complications) in addition to multiple DFU, infection, gangrene and DFU affecting bone. This model had an AUC of 0.91 [confidence interval (CI) 95% 0.87-0.95] and as classification of 0.89 (CI 95% 0.84-0.93) for LEA prediction. The high risk group presented a positive likelihood ratio of 5 (CI 95% 3?8) and predictive value of 58 (46?71). Only 1 minor LEA occurred in the low risk group.

Conclusions/interpretation
We propose a new classification: DIAFORA (DIAbetic Foot Risk Assessment). This classification was equally or more accurate for LEA prediction in DFU patients when compared to the existing ones.
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NewsBot · Apr 26, 2020

Inter-rater reliability assessment of new diabetic foot ulcers (The Diabetic Foot Ulcer Assessment Scale) based on photograph
HasniatiHaeruddin et al
Enfermería Clínica; Volume 30, Supplement 2, March 2020, Pages 433-438

Objective
The aim of this study is to evaluate the reliability of the Diabetic Foot Ulcer Assessment Scale (DFUAS) among different nurses.

Method
This research design was a comparison measurement between wound care nurses. The forward translation of DFUAS was translated into Indonesian and used to evaluated DFU status based on a photograph DFUAS that has been translated into Bahasa was used to evaluate the DFU status based on photographs. Cohen's kappa was used to evaluate inter reliability between nurses.

Results
The Cohen's kappa revealed that the inter-rater reliability for depth (0.76–0.80), size (0.80–0.86), size score (0.87–0.89), inflammation/infection (0.69–0.75), proportion of granulation tissue (0.73–0.79), type of necrotic tissue (0.65–0.73), proportion of necrotic tissue (0.87–0.89), proportion of slough (0.58–0.65), maceration (0.79–0.85), type of wound edge (0.91–0.93), and tunneling (0.90–0.91).

Conclusion
This study confirmed DFUAS has an adequate reliability between different wound nurses (inter-rater reliability).
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