Background
Methods
Phase one – development of the tool
Phase two – validity and reliability
Setting and participants
Procedures
Criterion measure
Criterion validity
Inter-rater reliability
Intra-rater reliability
Statistical analysis
Results
Phase one – development of the tool
QHRFF item | Supporting tool or literature |
---|---|
General demographics*
| [35] |
Indigenous status | [14] |
Health professionals attending*
| |
Medical co-morbidity history*
| |
Medical (diabetes) history | |
Diabetes year diagnosed (duration) | |
Recent BGLs > 15 mmol/L | |
HbA1c result | |
CKD | |
ESRF | |
High-risk factor history*
| |
Clinical diagnoses of high-risk factors
| |
Neuropathy | |
PAD | |
Acute Charcot | |
Foot deformity | |
Risk classification | |
Clinical diagnoses of foot disease
| |
(Ulcer) type | |
Combined surface area mm2
| |
Combined surface area (change since last visit) | |
Clinical signs of infection | |
UTWCS grade | |
Ulcer depth# | |
Clinical management principles performed*
|
Phase two – validity and reliability
Criterion measure | Criterion validity* & inter-rater reliability* | Intra-rater reliability | p Value | |
---|---|---|---|---|
General demographics
| ||||
Numbers | 32 | 43 | 19 | |
Male | 25 (78%) | 37 (86%) | 17 (90%) | 0.501 |
Age, mean (SD) (years)# | 69 (13) | 68 (13) | 70 (15) | 0.826 |
Age range (years) | 48 – 90 | 36 – 89 | 42 – 90 | |
Indigenous | 1 (3%) | 0 (0%) | 1 (5%) | NA |
Health professionals attending (in the past week)
| ||||
Podiatrist | 32 (100%) | 43 (100%) | 19 (100%) | 1.000 |
GP | 2 (6%) | 10 (23%) | 2 (11%) | 0.103 |
Nurse | 3 (9%) | 12 (28%) | 4 (21%) | 0.141 |
Orthotist | 0 | 0 | 0 | NA |
Physician | 2 (6%) | 1 (2%) | 1 (5%) | NA |
Surgeon | 1 (3%) | 3 (7%) | 0 | NA |
Other | 0 | 0 | 0 | NA |
Medical co-morbidity history
| ||||
Diabetes (type 1 or 2) | 28 (88%) | 35 (81%) | 16 (84%) | 0.384 |
Type 2 diabetes | 28 (88%) | 31 (72%) | 14 (74%) | 0.256 |
Diabetes duration (years)# | 12 (7) | 23 (11) | 20 (14) | 0.001** |
Recent BGLs > 15 mmol/L | 5 (16%) | 4 (9%) | 5 (26%) | 0.220 |
HbA1c (SD)# | 9.2 (3.5) | 8.1 (1.6) | 8.4 (2.7) | 0.450 |
Hypertension | 28 (88%) | 30 (70%) | 11 (58%) | 0.053 |
Dyslipidaemia | 23 (72%) | 25 (58%) | 9 (47%) | 0.201 |
Smoker | 5 (16%) | 11 (26%) | 3 (16%) | 0.492 |
CVD | 21 (66%) | 21 (49%) | 9 (47%) | 0.281 |
CKD | 5 (16%) | 13 (30%) | 5 (26%) | 0.339 |
ESRF | 0 | 1 (2%) | 0 | NA |
Other (non-listed) | 29 (91%) | 36 (84%) | 11 (58%) | 0.013** |
High-risk history
| ||||
Neuropathy | 31 (97%) | 37 (86%) | 18 (95%) | 0.214 |
PAD | 14 (44%) | 21 (49%) | 8 (42%) | 0.853 |
Previous foot ulcer | 27 (84%) | 37 (86%) | 17 (90%) | 0.878 |
Current foot ulcer | 32 (100%) | 42 (98%) | 19 (100%) | 0.549 |
New foot ulcer | 21 (66%) | 42 (98%) | 19 (100%) | ≤ 0.001** |
Previous amputation | 16 (50%) | 17 (40%) | 7 (37%) | 0.566 |
Clinical diagnoses of high-risk factors
| ||||
Neuropathy | 31 (97%) | 38 (88%) | 19 (100%) | 0.146 |
Any PAD | 14 (44%) | 22 (51%) | 8 (42%) | 0.735 |
Acute Charcot | 1 (3%) | 1 (2%) | 0 | NA |
Foot deformity | 26 (81%) | 33 (77%) | 17 (90%) | 0.501 |
Acute risk classification | 32 (100%) | 42 (98%) | 19 (100%) | 0.549 |
Clinical diagnoses of foot disease
| ||||
Ulcer type: neuropathic | 14 (44%) | 14 (33%) | 8 (42%) | 0.572 |
Ulcer type: neuroischaemic | 9 (28%) | 16 (37%) | 8 (42%) | 0.555 |
Ulcer type: ischaemic | 0 | 3 (7%) | 1 (5%) | NA |
Ulcer type: other | 9 (28%) | 9 (21%) | 2 (11%) | 0.339 |
Combined surface area (mm2)# | 122 (191) | 352 (899) | 379 (1436) | 0.469 |
Any clinical infection | 6 (19%) | 14 (33%) | 2 (11%) | 0.125 |
UTWCS (Grade 1A) | 13 (41%) | 14 (33%) | 7 (37%) | 0.770 |
Deep ulcer (Grade 2 or 3)^ | 8 (25%) | 6 (14%) | 2 (11%) | 0.394 |
Criterion measure
QHRFF item | % |
K(SE) | Strength of agreement [[37]] |
---|---|---|---|
General demographics
| |||
Indigenous status* | 77.4 | 0.45 (0.17) | Moderate |
Health professionals attending (in the past week)
| |||
Podiatrist | 96.9 | -- | -- |
GP | 81.2 | 0.78 (0.21) | Substantial |
Nurse | 84.4 | 0.47 (0.18) | Moderate |
Orthotist | 100 | -- | -- |
Physician | 96.9 | 0.78 (0.21) | Substantial |
Surgeon | 100 | 1.00 (0.01) | Near perfect |
Other | 100 | -- | -- |
Medical co-morbidity history
| |||
Medical (diabetes) history | 100 | 1.00 (0.01) | Near perfect |
Diabetes duration# | 0.94 (0.88–0.98) | Strong | |
Recent BGLs > 15 mmol/L* | 90.6 | 0.81 (0.11) | Near perfect |
HbA1c result# | 0.93 (0.79–0.98) | Strong | |
Hypertension | 87.5 | 0.60 (0.17) | Moderate |
Dyslipidaemia | 75.0 | 0.46 (0.16) | Moderate |
Smoker | 96.9 | 0.89 (0.11) | Near perfect |
CVD | 93.8 | 0.86 (0.10) | Near perfect |
CKD | 100 | 1.00 (0.01) | Near perfect |
ESRF | 96.9 | -- | -- |
Other (non-listed) | 46.9 | 0.04 (0.09) | Slight |
High-risk history
| |||
Neuropathy | 93.8 | 0.48 (0.31) | Moderate |
PAD | 84.4 | 0.68 (0.13) | Substantial |
Previous foot ulcer | 84.4 | 0.45 (0.21) | Moderate |
Current foot ulcer | 96.9 | -- | -- |
New foot ulcer | 83.9 | 0.58 (0.15) | Moderate |
Previous amputation | 90.6 | 0.81 (0.10) | Near perfect |
Clinical diagnoses of high-risk factors
| |||
Neuropathy | 96.9 | 0.65 (0.32) | Substantial |
PAD* | 77.4 | 0.61 (0.12) | Substantial |
Acute Charcot | 100 | 1.00 (0.01) | Near perfect |
Foot deformity | 81.3 | 0.46 (0.19) | Moderate |
Risk classification* | 96.8 | -- | -- |
Clinical diagnoses of foot disease
| |||
Ulcer type* | 87.5 | 0.85 (0.08) | Near perfect |
Combined surface area mm2# | 0.73 (0.52-0.86) | Moderate | |
Clinical signs of infection* | 84.3 | 0.68 (0.15) | Substantial |
UTWCS grade# | 0.56 (0.28–0.76) | Weak-moderate | |
Ulcer depth^ | 78.1 | 0.67 (0.13) | Substantial |
Clinical management principles performed
| |||
Debrided ulcer/callus* | 93.8 | -- | -- |
Dressing optimum* | 96.9 | -- | -- |
Antibiotics required* | 84.4 | 0.47 (0.19) | Moderate |
Off-loading optimum* | 68.8 | 0.41 (0.14) | Moderate |
Footwear optimum* | 65.6 | 0.28 (0.16) | Fair |
Educated patient* | 100 | -- | -- |
Criterion validity
QHRFF field | % |
K(SE) | Strength of agreement [[37]] | Sensitivity (95% CI) | Specificity (95% CI) | PPV (95% CI) |
---|---|---|---|---|---|---|
General demographics
| ||||||
Any indigenous status | 100 | -- | -- | -- | 1.00 (0.90-1.00) | -- |
Health professionals attending (in the past week)
| ||||||
Podiatrist | 100 | -- | -- | 1.00 (0.90-1.00) | -- | 1.00 (0.90-1.00) |
GP | 86.0 | 0.64 (0.14) | Substantial | 0.80 (0.44-0.96) | 0.88 (0.71-0.96) | 0.67 (0.35-0.88) |
Nurse | 93.0 | 0.83 (0.09) | Near perfect | 0.92 (0.60-1.00) | 0.94 (0.77-0.99) | 0.85 (0.54-0.97) |
Orthotist | 100 | -- | -- | -- | 1.00 (0.90-1.00) | -- |
Physician | 93.0 | -- | -- | 0 (0 – 0.95) | 0.95 (0.83-0.99) | 0 (0 – 0.80) |
Surgeon | 95.3 | 0.64 (0.24) | Substantial | 0.67 (0.13-0.98) | 0.98 (0.85-1.00) | 0.67 (0.13-0.98) |
Other | 100 | -- | -- | -- | 1.00 (0.90-1.00) | -- |
Medical co-morbidity history
| ||||||
Any medical (diabetes) history | 100 | 1.00 (0.01) | Near perfect | 1.00 (0.88-1.00) | 1.00 (0.60-1.00) | 1.00 (0.88-1.00) |
Diabetes duration# | 0.90 (0.80– 0.95) | Strong | ||||
Recent BGLs > 15 mmol/L | 93.0 | 0.69 (0.16) | Substantial | 0.57 (0.20-0.88) | 1.00 (0.88-1.00) | 1.00 (0.40-1.00) |
HbA1c result# | 1.00 (0.99–1.00) | Strong | ||||
Hypertension | 93.0 | 0.83 (0.09) | Near perfect | 0.97 (0.81-1.00) | 0.85 (0.54-0.97) | 0.94 (0.77-0.99) |
Dyslipidaemia | 95.3 | 0.90 (0.07) | Near perfect | 0.96 (0.78-1.00) | 0.94 (0.71-1.00) | 0.96 (0.78-1.00) |
Smoker | 90.7 | 0.72 (0.13) | Substantial | 0.64 (0.32-0.88) | 1.00 (0.87-1.00) | 1.00 (0.56-1.00) |
CVD | 90.7 | 0.81 (0.09) | Near perfect | 0.86 (0.63-0.96) | 0.95 (0.75-1.00) | 0.95 (0.72-1.00) |
CKD | 81.4 | 0.49 (0.15) | Moderate | 0.46 (0.20-0.74) | 0.97 (0.81-1.00) | 0.86 (0.42-0.99) |
ESRF | 1.00 | 1.00 (0.01) | Near perfect | 1.00 (0.05-1.00) | 1.00 (0.90-1.00) | 1.00 (0.05-1.00) |
Other (non-listed) | 57.1 | 0.09 (0.12) | Slight | 0.57 (0.40-0.73) | 0.57 (0.20-0.88) | 0.87 (0.65-0.97) |
High-risk history
| ||||||
Neuropathy | 93.0 | 0.73 (0.15) | Substantial | 0.95 (0.80-0.99) | 0.83 (0.36-0.99) | 0.97 (0.84-1.00) |
PAD | 88.4 | 0.77 (0.10) | Substantial | 0.86 (0.63-0.96) | 0.91 (0.69-0.98) | 0.90 (0.67-0.98) |
Previous foot ulcer | 79.1 | 0.28 (0.18) | Fair | 0.84 (0.67-0.93) | 0.50 (0.14-0.86) | 0.91 (0.75-0.98) |
Current foot ulcer | 95.3 | -- | -- | 0.98 (0.86-1.00) | 0 (0 – 0.95) | 0.98 (0.86-1.00) |
New foot ulcer | 93.0 | -- | -- | 0.95 (0.82-0.99) | 0 (0 – 0.95) | 0.98 (0.86-1.00) |
Previous amputation | 97.7 | 0.95 (0.05) | Near perfect | 0.94 (0.69-1.00) | 1.00 (0.84-1.00) | 1.00 (0.76-1.00) |
Clinical diagnoses of high-risk factors
| ||||||
Neuropathy | 97.7 | 0.90 (0.10) | Near perfect | 0.97 (0.85-1.00) | 1.00 (0.46-1.00) | 1.00 (0.88-1.00) |
Any PAD | 93.0 | 0.86 (0.8) | Near perfect | 0.91 (0.69-0.98) | 0.95 (0.74-1.00) | 0.95 (0.74-1.00) |
Acute Charcot | 100 | 1.00 (0.01) | Near perfect | 1.00 (0.05-1.00) | 1.00 (0.90-1.00) | 1.00 (0.05-1.00) |
Foot deformity | 86.0 | 0.51 (0.16) | Moderate | 1.00 (0.87-1.00) | 0.4 (0.14-0.73) | 0.85 (0.69-0.94) |
Acute risk classification | 97.7 | -- | -- | 1.00 (0.90-1.00) | 0 (0 – 0.95) | 0.98 (0.86-1.00) |
Clinical diagnoses of foot disease
| ||||||
Ulcer type: neuropathic (neuropathic or neuroisch.) | 90.7 | 0.76 (0.11) | Substantial | 0.88 (0.72-0.96) | 1.0 (0.63-1.00) | 1.00 (0.86-1.00) |
Ulcer type: ischaemic | 79.1 | 0.58 (0.13) | Moderate | 0.75 (0.51-0.90) | 0.83 (0.60-0.94) | 0.79 (0.54-0.93) |
(Neuroisch. or ischaemic) | ||||||
Combined surface area mm2# | 0.93 (0.87–0.96) | Strong | ||||
Any clinical infection | 88.4 | 0.72 (0.12) | Substantial | 0.71 (0.42-0.90) | 0.97 (0.80-1.00) | 0.91 (0.57-1.00) |
UTWCS (Grade 1A) | 83.7 | 0.65 (12) | Substantial | 0.85 (0.56-0.97) | 0.83 (0.64-0.93) | 0.71 (0.44-0.89) |
Deep ulcer | 95.3 | 0.81 (0.13) | Near perfect | 0.71 (0.30-0.95) | 0.97 (0.84-1.00) | 0.83 (0.36-0.99) |
(Grade 2 or 3)^ | ||||||
Clinical management principles performed
| ||||||
Ulcer debridement is required | 95.3 | 0.66 (0.01) | Substantial | 1.00 (0.89-1.00) | 1.00 (0.20-1.00) | 1.00 (0.89-1.00) |
Dressing is optimum | 100 | -- | -- | 1.00 (0.90-1.00) | -- | 1.00 (0.90-1.00) |
Antibiotics are required | 93.0 | 0.82 (0.10) | Near perfect | 0.83 (0.51-0.97) | 0.94 (0.77-0.99) | 0.83 (0.51-0.97) |
Off-loading is optimum | 93.0 | 0.80 (0.11) | Substantial | 0.80 (0.44-0.96) | 0.97 (0.82-1.00) | 0.89 (0.51-0.99) |
Footwear is optimum | 72.1 | 0.31 (0.16) | Fair | 0.50 (0.20-0.80) | 0.82 (0.64-0.92) | 0.45 (0.18-0.75) |
Educated patient | 97.7 | -- | -- | 0.98 (0.86-1.00) | -- | 1.00 (0.90-1.00) |
QHRFF field | % |
K(SE) | Strength of agreement [[37]] | Sensitivity (95% CI) | Specificity (95% CI) | PPV (95% CI) |
---|---|---|---|---|---|---|
General demographics
| ||||||
Any indigenous status | 100 | -- | -- | -- | 1.00 (0.90-1.00) | -- |
Health professionals attending (in the past week)
| ||||||
Podiatrist | 88.4 | -- | -- | 0.88 (0.74-0.96) | -- | 0.88 (0.74-0.96) |
GP | 81.4 | 0.39 (0.17) | Fair | 0.40 (0.14-0.73) | 0.94 (0.78-0.99) | 0.67 (0.24-0.94) |
Nurse | 79.1 | 0.37 (0.16) | Fair | 0.33 (0.11-0.65) | 0.97 (0.81-1.00) | 0.80 (0.30-0.99) |
Orthotist | 100 | -- | -- | -- | 1.00 (0.90–1.00) | -- |
Physician | 97.6 | 0.66 (0.32) | Substantial | 1.00 (0.05-1.00) | 0.98 (0.86-1.00) | 0.50 (0.03-0.97) |
Surgeon | 90.7 | 0.45 (0.23) | Moderate | 0.67 (0.13-0.98) | 0.93 (0.79-0.98) | 0.40 (0.07-0.83) |
Other | 100 | -- | -- | -- | 0.98 (0.86-1.00) | -- |
Medical co-morbidity history
| ||||||
Any medical (diabetes) history | 100 | 100 (0.01) | Near perfect | 1.00 (0.88-1.00) | 1.00 (0.60-1.00) | 1.00 (0.88-1.00) |
Diabetes duration# | 0.95 (0.90–0.97) | Strong | ||||
Recent BGLs > 15 mmol/L | 90.7 | 0.62 (0.17) | Substantial | 1.00 (0.40-1.00) | 0.90 (0.75-0.97) | 0.50 (0.17-0.83) |
HbA1c result# | 1.00 (0.99–1.00) | Strong | ||||
Hypertension | 86.0 | 0.68 (0.12) | Substantial | 0.87 (0.68-0.96) | 0.85 (0.54-0.97) | 0.93 (0.75-0.99) |
Dyslipidaemia | 79.1 | 0.58 (0.12) | Moderate | 0.76 (0.54-0.90) | 0.83 (0.58-0.96) | 0.86 (0.64-0.96) |
Smoker | 88.4 | 0.69 (0.13) | Substantial | 0.73 (0.39-0.93) | 0.94 (0.78-0.99) | 0.80 (0.44-0.96) |
CVD | 79.1 | 0.58 (0.12) | Moderate | 0.71 (0.48-0.88) | 0.86 (0.64-0.96) | 0.83 (0.58-0.96) |
CKD | 86.0 | 0.65 (0.13) | Substantial | 0.69 (0.39-0.90) | 0.93 (0.76-0.99) | 0.82 (0.48-0.97) |
ESRF | 97.7 | 0.66 (0.32) | Substantial | 1.00 (0.05-1.00) | 0.98 (0.86-1.00) | 0.50 (0.03-0.97) |
Other (non-listed) | 79.1 | 0.19 (0.19) | Slight | 0.89 (0.73-0.96) | 0.29 (0.05-0.7) | 0.86 (0.70-0.95) |
High-risk history
| ||||||
Neuropathy | 93.0 | 0.73 (0.15) | Substantial | 0.95 (0.80-0.99) | 0.83 (0.36-0.99) | 0.97 (0.84-1.00) |
PAD | 86.0 | 0.72 (0.10) | Substantial | 0.76 (0.52-0.91) | 0.95 (0.75-1.00) | 0.94 (0.69-1.00) |
Previous foot ulcer | 79.1 | 0.28 (0.18) | Fair | 0.84 (0.67-0.93) | 0.50 (0.14-0.86) | 0.91 (0.75-0.98) |
Current foot ulcer | 97.7 | -- | -- | 1.00 (0.90-1.00) | 0 (0 – 0.95) | 0.98 (0.86-1.00) |
New foot ulcer | 97.4 | -- | -- | 0.90 (0.76-0.97) | 0 (0 – 0.95) | 0.97 (0.85-0.99) |
Previous amputation | 95.3 | 0.90 (0.07) | Near perfect | 0.88 (0.62-0.98) | 1.00 (0.84-1.00) | 1.00 (0.75-1.00) |
Clinical diagnoses of high-risk factors
| ||||||
Neuropathy | 100 | 1.00 (0.01) | Near perfect | 1.00 (0.89-1.00) | 1.00 (0.46-1.00) | 1.00 (0.89-1.00) |
Any PAD | 95.3 | 0.91 (0.06) | Near perfect | 0.91 (0.69-0.98) | 1.00 (0.81-1.00) | 1.00 (0.80-1.00) |
Acute Charcot | 100 | 1.00 (0.01) | Near perfect | 1.00 (0.05-1.00) | 1.00 (0.90-1.00) | 1.00 (0.05-1.00) |
Foot deformity | 93.0 | 0.80 (0.11) | Substantial | 0.97 (0.82-1.00) | 0.80 (0.44-0.96) | 0.94 (0.79-0.99) |
Acute risk classify | 97.7 | -- | -- | 1.00 (0.90-1.00) | 0 (0 – 0.95) | 0.98 (0.86-1.00) |
Clinical diagnoses of foot disease
| ||||||
Ulcer type: neuropathic | 83.7 | 0.55 (0.14) | Moderate | 1.00 (0.86-1.00) | 0.46 (0.20-0.74) | 0.81 (0.64-0.91) |
(Neuropathic or neuroisch.) | ||||||
Ulcer type is ischaemic | 79.1 | 0.57 (0.13) | Moderate | 0.74 (0.48-0.90) | 0.83 (0.62-0.95) | 0.78 (0.52-0.93) |
(Neuroisch. or ischaemic) | ||||||
Combined surface area mm2# | 0.99 (0.99–1.00) | Strong | ||||
Any clinical infection | 81.4 | 0.58 (0.13) | Moderate | 0.71 (0.42-0.90) | 0.86 (0.67-0.95) | 0.71 (0.42-0.90) |
UTWCS (Grade 1A) | 81.4 | 0.61 (0.12) | Substantial | 0.86 (0.56-0.97) | 0.79 (0.60-0.91) | 0.69 (0.41-0.86) |
Deep ulcer | 93.0 | 0.73 (0.15) | Substantial | 0.71 (0.30-0.95) | 0.97 (0.84-1.00) | 0.83 (0.36-0.99) |
(Grade 2 or 3)^ | ||||||
Clinical management principles performed
| ||||||
Ulcer debridement is required | 95.3 | 0.39 (0.22) | Fair | 1.00 (0.89-1.00) | 0.50 (0.03-0.97) | 0.98 (0.86-1.00) |
Dressing is optimum | 97.7 | -- | -- | 0.98 (0.86-1.00) | -- | 1.00 (0.90-1.00) |
Antibiotics are required | 90.7 | 0.76 (0.11) | Substantial | 0.75 (0.43-0.93) | 0.97 (0.81-1.00) | 0.90 (0.54-0.99) |
Off-loading is optimum | 79.1 | 0.50 (0.14) | Moderate | 0.80 (0.44-0.96) | 0.79 (0.60-0.90) | 0.53 (0.27-0.78) |
Footwear is optimum | 79.1 | 0.47 (0.15) | Moderate | 0.70 (0.35-0.92) | 0.82 (0.64-0.92) | 0.54 (0.26-0.80) |
Educated patient | 100 | -- | -- | 1.00 (0.90-1.00) | -- | 1.00 (0.90-1.00) |
Inter-rater reliability
Inter-rater reliability | Intra-rater reliability | |||||
---|---|---|---|---|---|---|
QHRFF field | % |
K(SE) | Strength of agreement [[37]] | % |
K(SE) | Strength of agreement [[37]] |
General demographics
| ||||||
Indigenous status* | 83.7 | -- | -- | 100 | 1.00 (0.01) | Near Perfect |
Health professionals attending (in the past week)
| ||||||
Podiatrist | 88.4 | -- | -- | N/A | N/A | N/A |
GP | 81.4 | 0.45 (0.15) | Moderate | N/A | N/A | N/A |
Nurse | 81.4 | 0.47 (0.14) | Moderate | N/A | N/A | N/A |
Orthotist | 100 | -- | -- | N/A | N/A | N/A |
Physician | 90.7 | -- | -- | N/A | N/A | N/A |
Surgeon | 90.7 | 0.45 (0.23) | Moderate | N/A | N/A | N/A |
Other | 97.7 | -- | -- | N/A | N/A | N/A |
Medical co-morbidity history
| ||||||
Medical (diabetes) history | 95.3 | 0.94 (0.05) | Near perfect | 100 | 1.00 (0.01) | Near Perfect |
Diabetes duration# | 0.94 (0.87–0.97) | Strong | 1.00 (0.99–1.00) | Strong | ||
Recent BGLs >15 mmol/L* | 83.7 | 0.67 (0.12) | Substantial | N/A | N/A | N/A |
HbA1c result# | 1.00 (1.00–1.00) | Strong | 1.00 (1.00–1.00) | |||
Hypertension | 88.4 | 0.73 (0.11) | Substantial | 89.5 | 0.78 (0.15) | Substantial |
Dyslipidaemia | 83.7 | 0.67 (0.11) | Substantial | 94.7 | 0.90 (0.10) | Near Perfect |
Smoker | 88.4 | 0.64 (0.15) | Substantial | 94.7 | 0.83 (0.17) | Near Perfect |
CVD | 88.4 | 0.76 (0.10) | Substantial | 84.2 | 0.69 (0.17) | Substantial |
CKD | 86.1 | 0.58 (0.15) | Moderate | 94.7 | 0.86 (0.14) | Near Perfect |
ESRF | 97.7 | 0.66 (0.32) | Substantial | 100 | -- | -- |
Other (non-listed) | 69.1 | 0.34 (0.11) | Fair | 78.9 | 0.57 (0.19) | Moderate |
High-risk history
| ||||||
Neuropathy | 90.7 | 0.66 (0.16) | Substantial | 94.7 | -- | -- |
PAD | 83.7 | 0.67 (0.11) | Substantial | 78.9 | 0.60 (0.16) | Moderate |
Previous foot ulcer | 90.7 | 0.72 (0.13) | Substantial | 94.7 | 0.64 (0.33) | Substantial |
Current foot ulcer | 97.7 | -- | -- | 100 | -- | -- |
New foot ulcer | 97.4 | -- | -- | 100 | -- | -- |
Previous amputation | 97.7 | 0.95 (0.05) | Near perfect | 100 | 1.00 (0.01) | Near Perfect |
Clinical diagnoses of high-risk factors
| ||||||
Neuropathy | 97.7 | 0.90 (0.10) | Near perfect | 94.7 | -- | -- |
PAD* | 97.9 | 0.97 (0.03) | Near perfect | 84.2 | 0.69 (0.16) | Substantial |
Acute charcot | 100 | 1.00 (0.01) | Near perfect | 100 | -- | -- |
Foot deformity | 83.7 | 0.38 (0.18) | Fair | 84.2 | 0.31 (0.30) | Fair |
Risk classification | 100 | -- | -- | 100 | -- | -- |
Clinical diagnoses of foot disease
| ||||||
Ulcer type* | 88.4 | 0.81 (0.08) | Near perfect | 84.2 | 0.77 (0.14) | Substantial |
Combined surface area mm2# | 0.94 (0.89–0.97) | Strong | 1.00 (1.00–1.00) | Strong | ||
Clinical signs infection* | 76.7 | 0.60 (0.12) | Moderate | 89.5 | 0.46 (0.32) | Moderate |
UTWCS grade# | 0.90 (0.83–0.95) | Strong | 0.98 (0.94–0.99) | Strong | ||
Ulcer depth^ | 95.3 | 0.90 (0.10) | Near perfect | 94.7 | 0.79 (0.23) | Substantial |
Clinical management principles performed
| ||||||
Debrided ulcer/callus* | 97.7 | 0.66 (0.32) | Substantial | 94.7 | -- | -- |
Dressing optimum* | 97.7 | -- | -- | 100 | -- | -- |
Antibiotics required* | 79.1 | 0.54 (0.12) | Moderate | 89.5 | 0.44 (0.33) | Moderate |
Off-loading optimum* | 72.1 | 0.36 (0.13) | Fair | 68.4 | 0.32 (0.23) | Fair |
Footwear optimum* | 67.4 | 0.33 (0.14) | Fair | 68.4 | 0.37 (0.21) | Fair |
Educated patient* | 97.7 | -- | -- | 89.5 | -- | -- |