University of California Irvine School of Medicine, Irvine, CA, USA.
University of Michigan Medical School, Ann Arbor, MI, USA.
Diabetes Res Clin Pract. 2020 Mar;161:108074. doi: 10.1016/j.diabres.2020.108074. Epub 2020 Feb 25.
To assess the accuracy of once-daily foot temperature monitoring for predicting foot ulceration in diabetic patients with recent wounds and partial foot amputation, complications previously perceived as challenging.
We completed a planned analysis of existing data from a recent study in 129 participants with a previously-healed diabetic foot ulcer. We considered four cohorts: all participants, participants with partial foot amputation, participants with a recent wound, and participants without partial foot amputation and without a recent wound. We reported the prediction specificity, lead time, and annualized alert frequency in each cohort at maximum sensitivity. We assessed the two potentially challenging cohorts for non-inferior accuracy relative to the control cohort using Delong's method.
We report non-inferior predictive accuracy in each of the two potentially-challenging cohorts relative to the control cohort (⍺ < 0.05). The alert lead time was similar across these cohorts, ranging from 33 to 42 days.
Once-daily foot temperature monitoring is no less accurate for predicting foot ulceration in those with recent wounds and partial foot amputations than in those without these complications. These results support expanded practice of once-daily foot temperature monitoring, which may result in improved patient outcomes and reduced healthcare resource utilization.
评估每日一次的足部温度监测在预测近期伤口和部分足部截肢的糖尿病患者足部溃疡中的准确性，这些并发症以前被认为具有挑战性。
我们对最近一项研究中的 129 名既往愈合的糖尿病足溃疡患者的现有数据进行了计划分析。我们考虑了四个队列：所有参与者、部分足部截肢参与者、近期伤口参与者和无部分足部截肢且无近期伤口参与者。我们在最大灵敏度下报告了每个队列的预测特异性、领先时间和年化警报频率。我们使用 Delong 方法评估了两个潜在具有挑战性的队列相对于对照组的非劣效准确性。
我们报告了每个潜在具有挑战性的队列相对于对照组的非劣效预测准确性（⍺<0.05）。这些队列的警报领先时间相似，范围为 33 至 42 天。
每日一次的足部温度监测在预测近期伤口和部分足部截肢患者的足部溃疡方面的准确性并不逊于无这些并发症的患者。这些结果支持扩大每日一次的足部温度监测的应用，这可能会改善患者的结局并减少医疗保健资源的利用。
