Sharma S, Kerry C, Atkins H, Rayman G
Diabetes Research Unit, The Ipswich Hospital NHS Trust, Ipswich, UK.
Diabet Med. 2014 Sep;31(9):1100-3. doi: 10.1111/dme.12450. Epub 2014 Apr 11.
The Ipswich Touch Test is a novel method to detect subjects with diabetes with loss of foot sensation and is simple, safe, quick, and easy to perform and teach. This study determines whether it can be used by relatives and/or carers to detect reduced foot sensation in the setting of the patient's home.
The test involves lightly and briefly (1-2 s) touching the tips of the first, third and fifth toes of both feet with the index finger. Reduced foot sensation was defined as ≥ 2 insensate areas. Patients due to attend clinic over a 4-week period were invited by post. The invitation contained detailed instructions and a sheet for recording the results. The findings were compared with those obtained in clinic using the 10-g monofilament at the same six sites.
Of 331 patients (174 males), 25.1% (n = 83) had ≥ 2 insensate areas to 10-g monofilament testing. Compared with this, the Ipswich Touch Test at home had a sensitivity of 78.3% and a specificity of 93.9%. The predictive values of detecting 'at-risk' feet were positive at 81.2% and negative at 92.8%. The likelihood ratios were positive at 12.9 and negative at 0.23.
With clearly written instructions, this simple test can be used by non-professionals to accurately assess for loss of protective sensation. We believe that the Ipswich Touch Test may also be a useful educational adjunct to improve awareness of diabetes foot disease in patients and relatives alike and empower them to seek appropriate care if sensation was found to be abnormal.
伊普斯威奇触觉测试是一种检测足部感觉丧失的糖尿病患者的新方法，操作简单、安全、快速，易于实施和传授。本研究旨在确定亲属和/或护理人员能否在患者家中使用该测试来检测足部感觉减退。
该测试包括用食指轻轻短暂（1 - 2秒）触碰双脚的第一、第三和第五脚趾尖。足部感觉减退定义为≥2个感觉缺失区域。通过邮寄方式邀请预计在4周内就诊的患者。邀请函包含详细说明和一张记录结果的表格。将结果与在诊所使用10克单丝在相同六个部位获得的结果进行比较。
在331名患者（174名男性）中，25.1%（n = 83）在10克单丝测试中有≥2个感觉缺失区域。相比之下，在家中进行的伊普斯威奇触觉测试的灵敏度为78.3%，特异性为93.9%。检测“高危”足部的预测值阳性为81.2%，阴性为92.8%。似然比阳性为12.9，阴性为0.23。
通过清晰的书面说明，这种简单的测试可由非专业人员用于准确评估保护性感觉丧失。我们认为，伊普斯威奇触觉测试也可能是一种有用的教育辅助手段，可提高患者及其亲属对糖尿病足病的认识，并使他们在发现感觉异常时能够寻求适当的护理。
