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Clinical Care/Education/Nutrition

Surrogate End Points for the Treatment of Diabetic Neuropathic Foot Ulcers

  1. David J. Margolis, MD, PHD123,
  2. Joel M. Gelfand, MD12,
  3. Ole Hoffstad, MA2 and
  4. Jesse A. Berlin, SCD23
  1. 1Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
  2. 2Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
  3. 3Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
    Diabetes Care 2003 Jun; 26(6): 1696-1700. https://doi.org/10.2337/diacare.26.6.1696
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    Article Figures & Tables

    Tables

    • Table 1—

      Patient characteristics and week 4 surrogate characteristics for those who healed and those who did not by the 20th week of care and who were evaluated at week 4

      VariableHealedUnhealed
      Wounds15,382 (53.7)13,242 (46.3)
      Age (years)64 (54–73)65 (54–74)
      Wound size (mm2)133 (49–401)255 (82–827)
      Wound duration (months)1 (0.5–3)2 (0.75–5)
      Log wound size (mean)4.97 (0.012)5.59 (0.014)
      Log wound duration0.36 ± 1.400.73 ± 0.01
      Log rate0.062 ± 0.00060.007 ± 0.0004*
      Percent change−0.016 ± 0.06*−1.02 ± 0.25*
      Ratio of log areas0.64 ± 0.004*0.99 ± 0.003*
      • Data are n (%), median (25th–75th percentile), or mean ± SD unless otherwise indicated.

    • Table 2—

      The ROC curve area for surrogate end points measured after 2, 4, or 8 weeks for a 12- or 20-week healed outcome

      SurrogateWoundEnd pointROC curve
      Week 2Week 4Week 8
      Log ratePrimaryWeek 120.730.780.85
      Percent changePrimaryWeek 120.730.790.85
      Ratio of log areasPrimaryWeek 120.740.790.86
      Log rateAllWeek 120.750.790.85
      Percent changeAllWeek 120.750.800.86
      Ratio of log areasAllWeek 120.760.800.86
      Log ratePrimaryWeek 200.690.730.77
      Percent changePrimaryWeek 200.690.730.77
      Ratio of log areasPrimaryWeek 200.690.730.78
      Log rateAllWeek 200.720.760.78
      Percent changeAllWeek 200.720.760.78
      Ratio of log areasAllWeek 200.720.760.79
    • Table 3—

      Correct classification maximized dichotomous surrogate end points at 4 weeks for a 20-week healed outcome

      SurrogateWoundCut pointSensitivitySpecificityCorrect classification (%)
      Log rateAll0.03368.271.169.5
      Log ratePrimary0.04458.479.068.6
      Percent changeAll0.6168.271.269.6
      Percent changePrimary0.7158.579.068.6
      Ratio of log areasAll1.2368.871.970.2
      Ratio of log areasPrimary1.3459.079.669.2
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    Diabetes Care: 26 (6)

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    June 2003, 26(6)
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    Surrogate End Points for the Treatment of Diabetic Neuropathic Foot Ulcers
    David J. Margolis, Joel M. Gelfand, Ole Hoffstad, Jesse A. Berlin
    Diabetes Care Jun 2003, 26 (6) 1696-1700; DOI: 10.2337/diacare.26.6.1696

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    Surrogate End Points for the Treatment of Diabetic Neuropathic Foot Ulcers
    David J. Margolis, Joel M. Gelfand, Ole Hoffstad, Jesse A. Berlin
    Diabetes Care Jun 2003, 26 (6) 1696-1700; DOI: 10.2337/diacare.26.6.1696
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