• 1

    Boyko EJ, Ahroni JH, Smith DG, et al: Increased mortality associated with diabetic foot ulcer. .Diabet Med 13::967. ,1996. .

  • 2

    Payne C: The public health impact of diabetic foot disease. .Australas J Podiatr Med 31::115. ,1997. .

  • 3

    Borch-Johnsen K, Lauritzen T, Glumer C, et al: Screening for type 2 diabetes: should it be now?. Diabet Med 20::175. ,2003. .

  • 4

    Apelqvist J, Bakker K, Van Houtum WH, et al: International Consensus on the Diabetic Foot, John Wiley & Sons, Amsterdam, the Netherlands. ,1999. .

    • PubMed
    • Export Citation
  • 5

    Smieja M, Hunt DL, Edelman D, et al: International Cooperative Group for Clinical Examination Research: Clinical examination for the detection of protective sensation in the feet of diabetic patients. .J Gen Intern Med 14::418. ,1999. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Edelman D, Sanders LL, Pogach L: Reproducibility and accuracy among primary care providers of a screening examination for foot ulcer risk among diabetic patients. .Prev Med 27::274. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Harding SP, Broadbent DM, Neoh C, et al: Sensitivity and specificity of photography and direct ophthalmoscopy in screening for sight threatening eye disease: the Liverpool Diabetic Eye Study. .BMJ 311::1131. ,1995. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    National Health and Medical Research Council: Management of Diabetic Retinopathy: Clinical Practice Guidelines, AGPS, Canberra, Australia. ,1997. .

    • PubMed
    • Export Citation
  • 9

    Phillips A: National Foot Care Project: National Training Manual and Evaluation Report, National Association of Diabetes Centres, Canberra, Australia. ,2000. .

    • PubMed
    • Export Citation
  • 10

    Leng GC, Fowkes FG: The Edinburgh Claudication Questionnaire: an improved version of the Who/Rose Questionnaire for use in epidemiological surveys. .J Clin Epidemiol 45::1101. ,1992. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Meijer JW, Smit AJ, Sonderen EV, et al: Symptom scoring systems to diagnose distal polyneuropathy in diabetes: the Diabetic Neuropathy Symptom score. .Diabet Med 19::962. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Whited JD, Hall RP, Simel DL, et al: Primary care clinicians’ performance for detecting actinic keratoses and skin cancer. .Arch Intern Med 157::985. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Diamond JE, Mueller MJ, Delitto A, et al: Reliability of a diabetic foot evaluation. .Phys Ther 69::797. ,1989. .

Validation of the Basic Foot Screening Checklist

A Population Screening Tool for Identifying Foot Ulcer Risk in People with Diabetes Mellitus

Virginia M. Bower Division of Clinical Services, Department of Podiatry, Royal Perth Hospital, Perth, Australia. Dr. Bower is now with Podiatric Medicine, Faculty of Medicine, Dentistry, and Health Sciences, University of Western Australia, Crawley, Western Australia.

Search for other papers by Virginia M. Bower in
Current site
Google Scholar
PubMed
Close
 MPH
and
Michael Hobbs Department of Population Health, Faculty of Medicine and Dentistry, University of Western Australia, Crawley, Australia.

Search for other papers by Michael Hobbs in
Current site
Google Scholar
PubMed
Close
 PhD

Background: We sought to evaluate the validity, reliability, and predictive value of the Basic Foot Screening Checklist.

Methods: Five hundred patients with type 2 diabetes mellitus and impaired glucose tolerance were screened by a generalist foot screener and a specialist podiatric physician to determine the sensitivity and specificity of the Basic Foot Screening Checklist. One hundred twelve of the 500 participants had their feet screened by two foot screeners to determine reliability.

Results: The sensitivity of the screening tool was 0.54 (95% confidence interval, 0.50–0.58), and the specificity was 0.77 (95% confidence interval, 0.73–0.81), with a positive predictive value of 0.82 (95% confidence interval, 0.79–0.85). Overall, the reliability of the tool was poor (κ = 0.35; 95% confidence interval, 0.17–0.53).

Conclusions: The validity and reliability of the Basic Foot Screening Checklist was poor despite the finding that generalist foot screeners performed individual tests with good sensitivity and specificity. This inconsistency was likely attributable to the inability of screeners to adequately interpret the test findings and form accurate risk classification outcomes. (J Am Podiatr Med Assoc 99(4): 339–347, 2009)

Corresponding author: Virginia M. Bower, MPH, Podiatric Medicine, Faculty of Medicine, Dentistry, and Health Sciences, M422, University of Western Australia, 35 Stirling Hwy, Crawley, Western Australia, Australia 6009. (E-mail: virginia.bower@uwa.edu.au)
Save