The Tactile Circumferential Discriminator: A new, simple screening device to identify diabetic patients at risk of foot ulceration
- L Vileikyte, MD,
- G Hutchings, MD,
- S Hollis, MSC and
- A J M Boulton, MD, FRCP
- Department of Medicine, University of Lancaster Lancaster, U.K
- Manchester Royal Infirmary, Manchester Medical Statistics Unit, University of Lancaster Lancaster, U.K
- Address correspondence and reprint requests to A.J.M. Boulton, MD, FRCP, Department of Medicine, Manchester Royal Infirmary, Oxford Rd., Manchester M13 9WL, U.K.
Abstract
OBJECTIVE To evaluate the tactile circumferential discriminator (TCD) (Tacticon Medical Enterprises, West Chester, PA), a new, simple, handheld quantitative sensory testing device, in the identification of patients at potential risk of neuropathic ulceration.
RESEARCH DESIGN AND METHODS Patients with diabetes (n = 133) attending the Manchester Diabetes Centre or diabetic foot clinic seen within a 5-week period were assessed using the TCD, monofilaments, and vibration perception threshold (VPT) measured over the hallux. The sensitivity and specificity of each method in the identification of “high-risk” patients were compared.
RESULTS The TCD was easy to use, and there was a highly significant correlation between the results obtained compared with both filaments and VPT (P < 0.0001). Similarly, in the identification of patients at risk of ulceration, the TCD agreed with VPT in 75.2% of cases and with the monofilaments in 78.9%. In the identification of the 37 foot ulcer patients, TCD was highly sensitive (100%) but less specific (58.3%) than VPT (86.5%; 79.2%) and the monofilaments (91.9%; 76.0%).
CONCLUSIONS These data suggest that the TCD is a simple and reliable new technique for population screening for neuropathy and foot ulcer risk.
- Received September 9, 1996.
- Accepted November 4, 1996.
- Copyright © 1997 by the American Diabetes Association
