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Multicenter Study
. 2018 Oct;15(5):686-694.
doi: 10.1111/iwj.12911. Epub 2018 Mar 13.

Predicting the likelihood of venous leg ulcer recurrence: The diagnostic accuracy of a newly developed risk assessment tool

Kathleen J Finlayson  1   2   3 , Christina N Parker  1   2   3 , Charne Miller  4   5 , Michelle Gibb  3 , Suzanne Kapp  6   7 , Rajna Ogrin  8 , Jacinta Anderson  9 , Kerrie Coleman  10 , Dianne Smith  10 , Helen E Edwards  1   2   3
Affiliations
Multicenter Study

Predicting the likelihood of venous leg ulcer recurrence: The diagnostic accuracy of a newly developed risk assessment tool

Kathleen J Finlayson et al. Int Wound J. 2018 Oct.

Abstract

The aim of this study was to validate a newly developed tool for predicting the risk of recurrence within 12 months of a venous leg ulcer healing. Performance of the tool to predict recurrence within a 12-month period was assessed using Area Under the Receiver Operating Characteristic Curve (AUC) analysis. Multi-site retrospective and prospective longitudinal studies were undertaken to validate a risk assessment tool for the recurrence of venous leg ulcers within 12 months. In the retrospective study (n = 250), 55% of venous leg ulcers recurred within 12 months, and the risk assessment total score had excellent discrimination and goodness of fit with an AUC of 0.83 (95% CI, 0.76-0.90, P < .001). The prospective study (n = 143) observed that 50.4% (n = 63) of venous leg ulcers recurred within 12 months of healing. Participants were classified using the risk assessment tool as being at low risk (28%), moderate risk (59%), and high risk (13%); the proportion of wounds recurring at 12 months was 15%, 61%, and 67% for each group, respectively. Validation results indicated good discrimination and goodness of fit, with an AUC of 0.73 (95% CI, 0.64-0.82, P < .001). Validation of this risk assessment tool for the recurrence of venous leg ulcers provides clinicians with a resource to identify high-risk patients and to guide decisions on adjunctive, tailored interventions to address the specific risk factors to decrease the risk of recurrence.

Keywords: recurrence; risk assessment; validation; venous leg ulcers.

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Figures

Figure 1
Figure 1
Retrospective analysis: ROC Curve for subscales and total risk assessment score
Figure 2
Figure 2
Prospective validation Sample—AUC Results for the sub‐scores and total risk assessment score
Figure 3
Figure 3
Ulcer recurrence rates over 12 months in retrospective and prospective studies
See this image and copyright information in PMC

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