External validation of the Diabetic Foot Risk Assessment (DIAFORA) system to predict lower‐extremity amputations in a prospective Danish cohort
Authors' conclusion
The DIAFORA score is a useful tool for risk stratification of people presenting with a newly occurred DFU, with the external validation presenting results similar to those presented in the original study. The DIAFORA score may guide clinicians towards more individualized DFU treatment regimens.
Study context
- Population
- People presenting with a new DFU, Danish cohortall completed ≥3 months follow-up
- Participants
- 317 people
- Exposure
- DIAFORA risk categories: low, medium, high
- Outcome
- Discriminative accuracy of DIAFORA risk groups for major lower-extremity amputation (LEA) (sensitivity, specificity, likelihood ratios (LRs), AUC)
- Follow-up
- Until healing, LEA, death, or at least 3 months
Methodological detailsexternal validation of a prediction score
- External validation of a prediction score
Main finding
As reported in the abstract
Prediction of major LEA · median follow-up 146 days
| Group | Value | Negative LR | Positive LR |
|---|---|---|---|
| Low-risk | 0.9% | 0.10 | |
| Medium-risk | 2.1% | 0.38 | |
| High-risk | 25.0% | 12.9 |
Value
Low-risk0.9%
Medium-risk2.1%
High-risk25.0%
Negative LR
Low-risk0.10
Medium-risk0.38
High-risk— not stated in the abstract
Positive LR
Low-risk— not stated in the abstract
Medium-risk— not stated in the abstract
High-risk12.9
- Sensitivity of DIAFORA risk groups
- 75.0%
- Specificity of DIAFORA risk groups
- 65.7%
- AUC
- 0.78 (95% CI 0.68-0.87)
Observational data: associations, not effects.
Further findings
Amputation during follow-up, whole cohort · median 146 days
- Minor amputation
- 12.6%
- Major amputation
- 2.5%
Original publication
External validation of the DIAFORA system to predict lower‐extremity amputations in a prospective Danish cohort. Diabet Med. Published 28 September 2024. doi:10.
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