Abstract
The amputation rate in patients with diabetes is 15 to 40 times higher than in patients without diabetes. To avoid major complications, the identification of high-risk in patients with diabetes through early assessment highlights as a crucial action. Clinician assessment tools are scales in which clinical examiners are specifically trained to make a correct judgment based on patient outcomes that helps to identify at-risk patients and monitor the intervention. The aim of this study is to carry out a systematic review of valid and reliable Clinician assessment tools for measuring diabetic foot disease-related variables and analysing their psychometric properties. The databases used were PubMed, Scopus, SciELO, CINAHL, Cochrane, PEDro, and EMBASE. The search terms used were foot, ankle, diabetes, diabetic foot, assessment, tools, instruments, score, scale, validity, and reliability. The results showed 29 validated studies with 39 Clinician assessment tools and six variables. There is limited evidence on all of the psychometric characteristics of the Clinician assessment tools included in this review, although some instruments have been shown to be valid and reliable for the assessment of diabetic neuropathy (Utah Early Neuropathy Scale or UENS); ulceration risk (Queensland High Risk Foot Form or QHRFF); diabetic foot ulcer assessment, scoring, and amputation risk (Perfusion, extent, depth, infection and sensation scale or PEDIS and Site, Ischemia, Neuropathy, Bacterial Infection, and Depth score or SINBAD); and diabetic foot ulcer measurement (Leg Ulcer Measurement Tool LUMT).
Highlights
Diabetes is a chronic disease that might lead to several systemic complications, such as diabetic foot disease (DFD), a common condition with a global prevalence of 6.3%, which is known to affect wound onset and healing [1]
The study subjects were patients with DFD, which included those with diabetic foot or diabetic neuropathy [11], regardless of the type of diabetes, intervention, gender, or age
The most popular validation method for clinician assessment tools or scales was the calculation of psychometric properties that were based on 2 × 2 contingency tables, used in 17 out of 29 studies
Summary
Diabetes is a chronic disease that might lead to several systemic complications, such as diabetic foot disease (DFD), a common condition with a global prevalence of 6.3%, which is known to affect wound onset and healing [1]. Patients often require a minor or major amputation, which negatively affects their quality of life and survival [2,3]. The amputation rate in the diabetic population is 15 to 40 times higher than in non-diabetic patients [4]; DFD translates into high social impact and poor clinical prognosis, creating a heavy burden for health services [5]. The identification of high-risk diabetic patients through early assessment remains the primary action to avoid major complications [6]. For this purpose, valid and reliable instruments are required in order to assess diabetic foot-related variables
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