Alahakoon, Chanika, Fernando, Malindu, Galappaththy, Charith, Lazzarini, Peter, Moxon, Joseph V., Jones, Rhondda, and Golledge, Jonathan (2023) Repeatability, completion time, and predictive ability of four diabetes-related foot ulcer classification systems. Journal of Diabetes Science and Technology, 17 (1). pp. 35-41.

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Abstract

Introduction: The inter and intra-observer reproducibility of measuring the Wound Ischemia foot Infection (WIfI) score is unknown. The aims of this study were to compare the reproducibility, completion times and ability to predict 30-day amputation of the WIfI, University of Texas Wound Classification System (UTWCS), Site, Ischemia, Neuropathy, Bacterial Infection and Depth (SINBAD) and Wagner classifications systems using photographs of diabetes-related foot ulcers.

Methods: Three trained observers independently scored the diabetes-related foot ulcers of 45 participants on two separate occasions using photographs. The inter- and intra-observer reproducibility were calculated using Krippendorff's α. The completion times were compared with Kruskal-Wallis and Dunn's post-hoc tests. The ability of the scores to predict 30-day amputation rates were assessed using receiver operator characteristic curves and area under the curves.

Results: There was excellent intra-observer agreement (α >0.900) and substantial agreement between observers (α=0.788) in WIfI scoring. There was moderate, substantial, or excellent agreement within the three observers (α>0.599 in all instances except one) and fair or moderate agreement between observers (α of UTWCS=0.306, α of SINBAD=0.516, α of Wagner=0.374) for the other three classification systems. The WIfI score took significantly longer (P<.001) to complete compared to the other three scores (medians and inter quartile ranges of the WIfI, UTWCS, SINBAD, and Wagner being 1.00 [0.88-1.00], 0.75 [0.50-0.75], 0.50 [0.50-0.50], and 0.25 [0.25-0.50] minutes). None of the classifications were predictive of 30-day amputation (P>.05 in all instances).

Conclusion: The WIfI score can be completed with substantial agreement between trained observers but was not predictive of 30-day amputation.

Item ID:	67070
Item Type:	Article (Research - C1)
ISSN:	1932-2968
Keywords:	diabetes-related foot ulcers; diabetic foot; prediction of amputation; reproducibility; telemedicine
Related URLs:	https://researchonline.jcu.edu.au/81196/
Copyright Information:	© 2021 Diabetes Technology Society
Funders:	Townsville and Hospital Health Services (SERTA), James Cook University (JCU), Queensland Government, National Health and Medical Research Council of Australia (NHMRC)
Projects and Grants:	NHMRC 1117061
Date Deposited:	17 Jun 2021 02:10
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320199 Cardiovascular medicine and haematology not elsewhere classified @ 100%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100%
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