DOS 2018

DOS Kongressen 2018 · 207 Assessment of diabetic foot ulcers based on a pictorial material. An interobserver study Tue Smith Jørgensen, Ylva Hellsten, Hans Gottlieb, Stig Brorson Department of Orthopedic Surgery, Herlev Hospital; Nutrition exercise and sports, Science, University of Copenhagen; Department of Orthopedic Surgery, Zealand University Hospital Background: Diabetic foot ulcers represent a broad range of pathophysiologi- cal patterns in a heterogeneous patient population, and standardized treatment recommendations are difficult to establish. Adequate classification and docu- mentation of diabetic foot ulcers is essential to evaluate the wound healing ten- dency, facilitate communication between clinicians and to help predict which ulcers are likely to heal. Purpose / Aim of Study: Therefore, the aim of this study was to assess the interobserver agreement of a commonly used classification system for diabetic foot ulcers; the Meggitt-Wagner Classification, and to compare the agreement on classification to the agreement in treatment recommendations. Materials and Methods: An interobserver study was conducted based on a questionnaire linked to 30 photographs of diabetic foot ulcers. Three groups of observers were tested: 1) experienced orthopedic wound care doctors (n=7), 2) nurses specialized in wound care (n=8) 3) untrained nurses assigned to a diabetic wound care training course (n=23). Krippendorff’s alpha was used for calculating interobserver agreement, and an agreement >0.6 was defined as substantial. Findings / Results: The Krippendorffs alpha value for interobserver agreement on the Meggitt-Wagner Classification was 0.52 for the doctors. 0.67 for the specialized nurses and 0.61for the untrained nurses. The corresponding val- ues regarding agreement on recommendation of surgical revision of the wound, were 0.35, 0.22 and 0.15. Conclusions: The inter observer agreement on the Meggitt- Wagner classifi- cation was substantial, but the agreement on recommendation of surgical revi- sion was not. Whether Meggitt- Wagners Classification is only applicable in a re- search purpose and not in a clinical setting is not possible to answer in this study. 148.