Interclinician variation in diabetes foot assessment--a national lottery?

The aim was to evaluate variation among clinicians in the outcome of assessments of foot health status and risk status in patients with diabetes.

Seventeen clinicians assessed three patients with diabetes using a standardized assessment form and risk classification system.

There was variation among clinicians in all aspects of the assessment; recording basic demographic information; taking a medical history; vascular and neurological assessments. Variation was also evident in the risk categories allocated to each of the three patients.

As a consequence of the variation among clinicians in the foot assessment the same patient would have received different care pathways to monitor and manage their foot health depending upon which clinician undertook their initial assessment. We therefore recommend that more attention is placed on training for objective clinical testing, at both pre- and postgraduate levels.