Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2011 Jul;34(7):1517-8.
doi: 10.2337/dc11-0156. Epub 2011 May 18.

The Ipswich Touch Test: a simple and novel method to identify inpatients with diabetes at risk of foot ulceration

Gerry Rayman  1 , Prashanth R Vas, Neil Baker, Charles G Taylor Jr, Catherine Gooday, Amanda I Alder, Mollie Donohoe
Affiliations
Comparative Study

The Ipswich Touch Test: a simple and novel method to identify inpatients with diabetes at risk of foot ulceration

Gerry Rayman et al. Diabetes Care. 2011 Jul.

Abstract

Objective: To promote foot screening of inpatients with diabetes, we simplified sensory testing to lightly touching the tips of the first, third, and fifth toes (the Ipswich Touch Test [IpTT]).

Research design and methods: Respective performances of the IpTT and 10-g monofilament (MF) were compared with a vibration perception threshold of ≥25 V indicating at-risk feet in 265 individuals. The IpTT and MF were also directly compared.

Results: With ≥2 of 6 insensate areas signifying at-risk feet, sensitivities and specificities, respectively, were IpTT (77 and 90%), MF (81 and 91%); positive predictive values were IpTT (89%), MF (91%); and negative predictive values were IpTT (77%), MF (81%). Directly compared, agreement between the IpTT and MF was almost perfect (κ=0.88, P<0.0001). Interrater agreement for the IpTT was substantial (κ=0.68).

Conclusions: The IpTT performs well against a recognized standard for ulcer prediction. Simple to teach, reliable, without expense, and always at hand, it should encourage uptake of screening and detection of high-risk inpatients requiring foot protection.

PubMed Disclaimer

References

    1. Abbott CA, Carrington AL, Ashe H, et al. ; North-West Diabetes Foot Care Study The North-West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort. Diabet Med 2002;19:377–384 - PubMed
    1. Leese GP, Reid F, Green V, et al. Stratification of foot ulcer risk in patients with diabetes: a population-based study. Int J Clin Pract 2006;60:541–545 - PubMed
    1. Adler AI, Boyko EJ, Ahroni JH, Stensel V, Forsberg RC, Smith DG. Risk factors for diabetic peripheral sensory neuropathy. Results of the Seattle Prospective Diabetic Foot Study. Diabetes Care 1997;20:1162–1167 - PubMed
    1. Rith-Najarian SJ, Stolusky T, Gohdes DM. Identifying diabetic patients at high risk for lower-extremity amputation in a primary health care setting. A prospective evaluation of simple screening criteria. Diabetes Care 1992;15:1386–1389 - PubMed
    1. Rayman G. The National Diabetes Inpatient Audit Day. A great success and a powerful tool with which to improve inpatient diabetes care. Summary of the paper presented to Diabetes UK APC March 2010 [article online], 2010. Available from http://diabetologists-abcd.org.uk/Shared_Documents/newsletters/ABCD_News... Accessed 14 December 2010

Publication types