Abstract
Purpose: The aim of this study was to validate the predictive accuracy of three international risk classification systems for diabetic foot ulcer occurrence. Methods: A secondary data analysis was conducted. The data were collected from a case-control study that recruited 367 patients with Type 2 diabetes (118 with existing foot ulcers and 261 without foot ulcers). The risk of foot ulcer occurrence was classified in accordance with the American Diabetes Association (ADA), the International Working Group on the Diabetic Foot (IWGDF), and the Scottish Intercollegiate Guidelines Network (SIGN) risk classification systems. The predictive validity of the classification systems was calculated to evaluate the systems’ performance. Results: The ADA, IWGDF, and SIGN systems had area under the receiver operating curve (AUC) with values of .91, .90, and .80, respectively, and the predictive accuracy of each classification system was 73.4~84.7% for ADA, 74.4~85.5% for IWGDF, and 49.6~73.9% for SIGN, depending on the cut-off points. Conclusion: All of the three classification systems showed good predictive accuracy. Further studies are needed to select one that is most accurate and cost-effective
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