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PODUS Models for Risk of Diabetic Foot Ulceration: Simple Prediction Rule

Description

Chappell et al reported a simple clinical prediction rule for predicting the risk of diabetic food ulceration. The same predictors can be combined using a logistic regression model. The authors are from multiple institutions in Scotland, England, the United States, and Portugal.


PODUS = Prediction Of Diabetic foot UlcerationS (project to predict diabetic foot ulcers)

 

Patient selection: diabetic without current foot ulceration

 

Parameters:

(1) sensitivity of testing to 10 g monofilament

(2) pedal pulses (dorsalis pedis, posterior tibial)

(3) history of previous ulcer or amputation

 

Parameter

Finding

Points

10 g monofilament test

sensitive

0

 

insensitive

1

pedal pulse

all present

0

 

any absent

1

history of ulcer or amputation

no

0

 

yes

2

 

total score =

= SUM(points for all of the parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 4

• A score >= 1 favors preventative measures.

 

Total Score

Risk of Ulceration within 2 Years

0

2.4%

1

6%

2

14%

3

29%

4

51%

 

Performance:

• The area under the ROC curve is 0.83.


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