The Queensland high risk foot form (QHRFF) - is it a reliable and valid clinical research tool for foot disease?

Lazzarini, Peter A., Ng, Vanessa., Kinnear, Ewan M., Kamp, Maarten C., Kuys, Suzanne S., Hurst, Cameron and Reed, Lloyd F. (2014) The Queensland high risk foot form (QHRFF) - is it a reliable and valid clinical research tool for foot disease?. Journal of Foot and Ankle Research, 7 1: . doi:10.1186/1757-1146-7-7


Author Lazzarini, Peter A.
Ng, Vanessa.
Kinnear, Ewan M.
Kamp, Maarten C.
Kuys, Suzanne S.
Hurst, Cameron
Reed, Lloyd F.
Title The Queensland high risk foot form (QHRFF) - is it a reliable and valid clinical research tool for foot disease?
Journal name Journal of Foot and Ankle Research   Check publisher's open access policy
ISSN 1757-1146
Publication date 2014-01-28
Year available 2014
Sub-type Article (original research)
DOI 10.1186/1757-1146-7-7
Open Access Status DOI
Volume 7
Issue 1
Total pages 18
Place of publication London, United Kingdom
Publisher BioMed Central
Language eng
Formatted abstract
Background
Foot disease complications, such as foot ulcers and infection, contribute to considerable morbidity and mortality. These complications are typically precipitated by “high-risk factors”, such as peripheral neuropathy and peripheral arterial disease. High-risk factors are more prevalent in specific “at risk” populations such as diabetes, kidney disease and cardiovascular disease. To the best of the authors’ knowledge a tool capturing multiple high-risk factors and foot disease complications in multiple at risk populations has yet to be tested. This study aimed to develop and test the validity and reliability of a Queensland High Risk Foot Form (QHRFF) tool.

Methods
The study was conducted in two phases. Phase one developed a QHRFF using an existing diabetes foot disease tool, literature searches, stakeholder groups and expert panel. Phase two tested the QHRFF for validity and reliability. Four clinicians, representing different levels of expertise, were recruited to test validity and reliability. Three cohorts of patients were recruited; one tested criterion measure reliability (n = 32), another tested criterion validity and inter-rater reliability (n = 43), and another tested intra-rater reliability (n = 19). Validity was determined using sensitivity, specificity and positive predictive values (PPV). Reliability was determined using Kappa, weighted Kappa and intra-class correlation (ICC) statistics.

Results
A QHRFF tool containing 46 items across seven domains was developed. Criterion measure reliability of at least moderate categories of agreement (Kappa > 0.4; ICC > 0.75) was seen in 91% (29 of 32) tested items. Criterion validity of at least moderate categories (PPV > 0.7) was seen in 83% (60 of 72) tested items. Inter- and intra-rater reliability of at least moderate categories (Kappa > 0.4; ICC > 0.75) was seen in 88% (84 of 96) and 87% (20 of 23) tested items respectively.

Conclusions
The QHRFF had acceptable validity and reliability across the majority of items; particularly items identifying relevant co-morbidities, high-risk factors and foot disease complications. Recommendations have been made to improve or remove identified weaker items for future QHRFF versions. Overall, the QHRFF possesses suitable practicality, validity and reliability to assess and capture relevant foot disease items across multiple at risk populations.
Keyword Foot
Disease
Tool
Valid
Reliable
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article no.: 7

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
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