Grading the loss of sensation in diabetic patients: A psychometric evaluation of the rotterdam diabetic foot study test battery

Rinkel, Willem D.; Rizopoulos, Dimitris; Aziz, Moutaz; Neck, Johan W. van; Cabezas, Manuel Castro; Coert, J. Henk

doi:10.1002/mus.26192

Cited by 18 publications

(46 citation statements)

References 39 publications

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“…These MNAs are expected to reach nerve termini in healthy populations. However, noting the fact that patients with diabetic ulcers are typically suffering from neuropathy and lack of sensation in their limbs, MNAs insertion will not cause any pain in patients 19. The designed MNAs are capable of infusing drugs with a controlled distribution., which is not easy to achieve with hypodermic needles because they are too long and are only able to target a single point.…”

Section: Resultsmentioning

confidence: 99%

A Wirelessly Controlled Smart Bandage with 3D‐Printed Miniaturized Needle Arrays

Derakhshandeh

Aghabaglou

McCarthy

et al. 2020

Adv Funct Materials

135

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Chronic wounds are one of the most devastating complications of diabetes and are the leading cause of nontraumatic limb amputation. Despite the progress in identifying factors and promising in vitro results for the treatment of chronic wounds, their clinical translation is limited. Given the range of disruptive processes necessary for wound healing, different pharmacological agents are needed at different stages of tissue regeneration. This requires the development of wearable devices that can deliver agents to critical layers of the wound bed in a minimally invasive fashion. Here, for the first time, a programmable platform is engineered that is capable of actively delivering a variety of drugs with independent temporal profiles through miniaturized needles into deeper layers of the wound bed. The delivery of vascular endothelial growth factor (VEGF) through the miniaturized needle arrays demonstrates that, in addition to the selection of suitable therapeutics, the delivery method and their spatial distribution within the wound bed is equally important. Administration of VEGF to chronic dermal wounds of diabetic mice using the programmable platform shows a significant increase in wound closure, re‐epithelialization, angiogenesis, and hair growth when compared to standard topical delivery of therapeutics.

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Section: Resultsmentioning

confidence: 99%

A Wirelessly Controlled Smart Bandage with 3D‐Printed Miniaturized Needle Arrays

Derakhshandeh

Aghabaglou

McCarthy

et al. 2020

Adv Funct Materials

135

View full text Add to dashboard Cite

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“…Data on incident diabetic foot ulceration was assessed at 1‐year follow‐up and included ulcer characteristics. RDF‐study design and methods are more elaborately communicated in previous papers . All subjects provided informed consent.…”

Section: Methodsmentioning

confidence: 99%

“…RDF-study design and methods are more elaborately communicated in previous papers. 10,12 All subjects provided informed consent. The Medical Ethics Research Committee of Erasmus MC Medical University Center, Rotterdam, the Netherlands approved the study (MEC-2009-148).…”

Section: Methodsmentioning

confidence: 99%

“…9 We investigated which tests and locations on the feet have the best predictive value regarding 1-year ulcer-free survival in diabetic subjects participating in the Rotterdam Diabetic Foot Study (RDFstudy). 8,10 Especially in a screening setting, sensitivity of tests are of value, because the beforementioned factors (eg, foot deformities) also contribute to the development of DFU. We distinguished between people with and without a history of DFU regarding the differences in relative risks and screening programmes.…”

Section: Introductionmentioning

confidence: 99%

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Predicting ulcer‐free survival using the discriminative value of screening test locations

Rinkel

Dijkstra

Cabezas

et al. 2019

Diabetes Metabolism Res

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Background Current guidelines recommend screening the feet of diabetic subjects with a 10‐g monofilament or tuning fork. We investigated which tests and locations on the feet have the best predictive value regarding 1‐year ulcer‐free survival in diabetic subjects participating in the prospective Rotterdam Diabetic Foot Study. Methods Decision tree analysis was used to predict ulcer‐free survival based on responses from individual test locations (monofilaments on 10 sites, vibration sense was tested on both halluces and medial malleoli). Separate trees for patients with and without a history of diabetic foot ulcer (DFU) were developed. Results Four hundred sixteen subjects (mean [SD] age, 61.8 years [12.4]; range, 21.6‐90.2) were measured, of whom 24 developed new DFUs. Three tests exhibited discriminative and predictive properties: testing vibration sense on the medial malleolus and monofilament testing on heel and hallux. The decision tree to predict ulcer‐free survival in patients with a history of DFU yielded a sensitivity of 87.0%, which was 99.6% for the tree of patients without a history of DFU. Conclusion The findings of this study aids medical decision making by discriminating between high‐ and low‐risk patients of developing DFU using selective testing on sites with predictive properties.

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“…5 Because not every patient with positive sensory symptoms has sensory loss, it is useful to focus on objective measures such as foot sensation to assess large-fiber nerve function. 6 Loss of sensation can be assessed with several instruments. 7,8 Current guidelines recommend an annual screening with a 10-g Semmes-Weinstein monofilament (SWM) or a tuning fork.…”

Section: Introductionmentioning

confidence: 99%

Development of grading scales of pedal sensory loss using Mokken scale analysis on the Rotterdam Diabetic Foot Study Test Battery data

et al. 2019

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IntroductionLoss of sensation due to diabetes‐related neuropathy often leads to diabetic foot ulceration. Several test instruments are used to assess sensation, such as static and moving 2‐point discrimination (S2PD, M2PD), monofilaments, and tuning forks.MethodsMokken scale analysis was applied to the Rotterdam Diabetic Foot Study data to select hierarchies of tests to construct measurement scales.ResultsWe developed 39‐item and 31‐item scales to measure loss of sensation for research purposes and a 13‐item scale for clinical practice. All instruments were strongly scalable and reliable. The 39 items can be classified into 5 hierarchically ordered core clusters: S2PD, M2PD, vibration sense, monofilaments, and prior ulcer or amputation.DiscussionGuided by the presented scales, clinicians may better classify the grade of sensory loss in diabetic patients’ feet. Thus, a more personalized approach concerning individual recommendations, intervention strategies, and patient information may be applied.

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Grading the loss of sensation in diabetic patients: A psychometric evaluation of the rotterdam diabetic foot study test battery

Cited by 18 publications

References 39 publications

A Wirelessly Controlled Smart Bandage with 3D‐Printed Miniaturized Needle Arrays

A Wirelessly Controlled Smart Bandage with 3D‐Printed Miniaturized Needle Arrays

Predicting ulcer‐free survival using the discriminative value of screening test locations

Development of grading scales of pedal sensory loss using Mokken scale analysis on the Rotterdam Diabetic Foot Study Test Battery data

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