Diabetes Research Centre, Ipswich Hospital National Health Service Trust, Suffolk, UK.
Diabetes Care. 2011 Jul;34(7):1517-8. doi: 10.2337/dc11-0156. Epub 2011 May 18.
To promote foot screening of inpatients with diabetes, we simplified sensory testing to lightly touching the tips of the first, third, and fifth toes (the Ipswich Touch Test [IpTT]).
Respective performances of the IpTT and 10-g monofilament (MF) were compared with a vibration perception threshold of ≥25 V indicating at-risk feet in 265 individuals. The IpTT and MF were also directly compared.
With ≥2 of 6 insensate areas signifying at-risk feet, sensitivities and specificities, respectively, were IpTT (77 and 90%), MF (81 and 91%); positive predictive values were IpTT (89%), MF (91%); and negative predictive values were IpTT (77%), MF (81%). Directly compared, agreement between the IpTT and MF was almost perfect (κ=0.88, P<0.0001). Interrater agreement for the IpTT was substantial (κ=0.68).
The IpTT performs well against a recognized standard for ulcer prediction. Simple to teach, reliable, without expense, and always at hand, it should encourage uptake of screening and detection of high-risk inpatients requiring foot protection.
为了促进糖尿病住院患者的足部筛查，我们简化了感觉测试，仅轻轻触摸第一、第三和第五脚趾的尖端（伊普斯威奇触摸测试[IpTT]）。
将 IpTT 和 10-g 单丝（MF）的各自表现与振动感觉阈值≥25 V 进行比较，表明 265 名个体中有风险的足部。还直接比较了 IpTT 和 MF。
用≥6 个无感觉区域中的 2 个表示有风险的足部，敏感性和特异性分别为 IpTT（77%和 90%），MF（81%和 91%）；阳性预测值为 IpTT（89%），MF（91%）；阴性预测值为 IpTT（77%），MF（81%）。直接比较时，IpTT 和 MF 之间的一致性几乎是完美的（κ=0.88，P<0.0001）。IpTT 的观察者间一致性很高（κ=0.68）。
IpTT 针对溃疡预测的公认标准表现良好。它易于教授、可靠、无需花费且随时可用，应该鼓励进行筛查，并发现需要足部保护的高风险住院患者。
