Evaluation of a self-administered sensory testing tool to identify patients at risk of diabetes-related foot problems

Diabetes Care. 1998 Jan;21(1):23-5. doi: 10.2337/diacare.21.1.23.


Objective: To study the use of a self-administered sensory testing tool designed to identify individuals at risk for diabetes-related foot problems and determine the inter-rater reliability between patient and provider sensory evaluations.

Research design and methods: Nine centers in eight states with established foot prevention centers mailed 196 self-screening testing materials to randomly selected patients with diabetes scheduled for follow-up appointments. Patients were instructed to perform a sensory test using a 10-g nylon filament at specified sites on the foot and to complete a brief survey form before their appointment. During the follow-up appointment, providers retested patients using an identical sensory filament at the same sites and completed a provider survey.

Results: Of the patients, 145 kept their appointments and completed the self-screening materials. There were 141 patient and 137 provider surveys that indicated the instructions were clear and easy to use. Sixty-eight percent of the patients reported self-testing without the assistance of another person. Patient and provider sensory test findings disagreed (P = 0.0014) in 18 of 145 cases and fair inter-rater reliability was found (kappa = 0.73). Disagreement in sensory tests was related to patient age (P = 0.012). Sensory loss, previously undetected by providers, was found in 23 case subjects.

Conclusions: Self-administered sensory tests provide patients an opportunity to share in the responsibility for preventing diabetes-related foot problems but should not replace routine foot evaluation by a provider.

Publication types

  • Multicenter Study

MeSH terms

  • Age Factors
  • Aged
  • Diabetic Foot / diagnosis
  • Diabetic Foot / epidemiology
  • Diabetic Foot / prevention & control*
  • Diabetic Neuropathies / diagnosis
  • Diabetic Neuropathies / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic
  • Power, Psychological
  • Reproducibility of Results
  • Risk Factors
  • Self-Examination*
  • Sensation*
  • Sex Factors