General Practitioners' Society (Yangon), Myanmar Medical Association, Yangon, Myanmar.
Grand Hantha International Hospital, Bayint Naung Tower 2, Kamayut Township, Yangon, Myanmar.
J ASEAN Fed Endocr Soc. 2022;37(1):31-37. doi: 10.15605/jafes.037.01.06. Epub 2022 Apr 4.
Proper foot assessment is important for early detection and treatment of diabetic peripheral neuropathy (DPN), the main cause of diabetic foot ulcers (DFUs). This study aimed to determine the accuracy and cost-effectiveness of the locally developed Diabetic Foot Screen (DFS) proforma in detecting DPN among diabetic patients at 10 selected clinics in Yangon, Myanmar.
The study included 625 type 2 diabetics from 10 primary care clinics who participated in the diagnostic accuracy and cost-effectiveness analysis. They were assessed with DFS proforma and biothesiometry by two examiners independently. The cost-effectiveness analysis was conducted based on available data in the local primary care setting.
The overall accuracy of the DFS proforma assessment was 74.76% (95% CI: 70.46%- 79.06%). The optimal cut-off DFS score was ≥1.5 (sensitivity 62%; specificity 76%) in detecting DPN. Compared to biothesiometry, the cost-effectiveness of DFS proforma assessment in DPN detection was 41.79 USD per DPN case detected.
This study supported the use of DFS proforma for DPN detection in primary care clinics. It also provided new information on the estimated costs per patient with DPN detected in Myanmar.
正确的足部评估对于早期发现和治疗糖尿病周围神经病变（DPN）至关重要，而 DPN 是糖尿病足溃疡（DFUs）的主要病因。本研究旨在确定在缅甸仰光的 10 家选定诊所中，当地开发的糖尿病足筛查（DFS）表单在检测糖尿病患者的 DPN 方面的准确性和成本效益。
本研究纳入了来自 10 家初级保健诊所的 625 名 2 型糖尿病患者，他们参与了诊断准确性和成本效益分析。他们由两名检查者使用 DFS 表单和生物感觉计独立进行评估。根据当地初级保健环境中的现有数据进行成本效益分析。
DFS 表单评估的总体准确性为 74.76%（95%CI：70.46%-79.06%）。检测 DPN 的最佳 DFS 评分临界值为≥1.5（灵敏度 62%，特异性 76%）。与生物感觉计相比，DFS 表单评估在 DPN 检测方面的成本效益为每例 DPN 检测 41.79 美元。
本研究支持在初级保健诊所中使用 DFS 表单进行 DPN 检测。它还提供了在缅甸每例检测到的 DPN 患者的估计成本的新信息。
