title: The Ipswich Touch Test: a simple and novel method to identify inpatients with diabetes at risk of foot ulceration.
abstract: OBJECTIVE
  To promote foot screening of inpatients with diabetes, we simplified sensory testing to lightly touching the tips of the first, third, and fifth toes (the Ipswich Touch Test [IpTT]).
  
  
  METHODS
  Respective performances of the IpTT and 10-g monofilament (MF) were compared with a vibration perception threshold of ≥25 V indicating at-risk feet in 265 individuals. The IpTT and MF were also directly compared.
  
  
  RESULTS
  With ≥2 of 6 insensate areas signifying at-risk feet, sensitivities and specificities, respectively, were IpTT (77 and 90%), MF (81 and 91%); positive predictive values were IpTT (89%), MF (91%); and negative predictive values were IpTT (77%), MF (81%). Directly compared, agreement between the IpTT and MF was almost perfect (κ=0.88, P<0.0001). Interrater agreement for the IpTT was substantial (κ=0.68).
  
  
  CONCLUSIONS
  The IpTT performs well against a recognized standard for ulcer prediction. Simple to teach, reliable, without expense, and always at hand, it should encourage uptake of screening and detection of high-risk inpatients requiring foot protection.
authors: Diabetes Research Centre, Ipswich Hospital National Health Service Trust, Suffolk, UK. gerry.rayman@ipswichhospital.nhs.uk
authors: Gerry
authors: G
authors: Rayman
authors: Prashanth R
authors: PR
authors: Vas
authors: Neil
authors: N
authors: Baker
authors: Charles G
authors: CG
authors: Taylor
authors: Catherine
authors: C
authors: Gooday
authors: Amanda I
authors: AI
authors: Alder
authors: Mollie
authors: M
authors: Donohoe
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