Reliability and predictive validity of Inlow's 60-Second Diabetic Foot Screen Tool.

ABSTRACT

OBJECTIVE: The purpose of this study was to assess Inlow's 60-Second Diabetic Foot Screen Tool to ascertain consistency of risk recognition for development of ulceration independent of specific assessor and practice setting. Screening tools that assist clinicians in identifying risk require validation. The objectives were to determine the intrarater reliability, interrater reliability, and predictive validity of Inlow's 60-Second Diabetic Foot Screen Tool in 2 healthcare settings. DESIGN: Following ethics board approval, a prospective observational study was completed. SETTING AND PARTICIPANTS: A convenience sample of 69 persons with diabetes was recruited n = 26 from an acute care setting (dialysis) and n = 43 from long-term-care (LTC) setting. MAIN OUTCOME MEASURES: The screening tool was administered by 2 assessors independently to determine interrater reliability and later the same day by one of the assessors to determine intrarater reliability. Occurrence of foot ulcers or amputation was noted 1 to 5 months later to determine predictive validity. MAIN RESULTS: Reliability is reported per setting using the intraclass correlation coefficient (2.1) and 95% confidence intervals. Intrarater reliability LTC 0.96 (0.93-0.98) right foot, 0.97 (0.95-0.98) left foot; dialysis 1.00 right and 1.00 left foot. Interrater reliability LTC 0.92 (0.86-0.96) right foot, 0.93 (0.87-0.96) left foot; dialysis 0.83 (0.65-0.92) right foot and left foot. Predictive validity Two subjects had events-1 ulcer and 1 amputation-that were associated with high Inlow's screening tool scores. CONCLUSION: This study demonstrates excellent interrater and intrarater reliability and provides preliminary information about predictive validity.