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Published on: March 11, 2022
Measurement Properties of Instruments Used to Assess Diabetic Foot: An Umbrella Review
Nagyeong Kim1, Youngshin Song1
1College of Nursing, Chungnam National University, Daejeon, Republic of Korea, cnu.ac.kr.
Journal of Diabetes Research
|June 11, 2026
Summary
Diabetic foot assessment tools lack rigorous psychometric evaluation, with most systematic reviews having high bias. Future research needs better validation studies for reliable instruments.
Area of Science:
- Diabetology
- Clinical Assessment Tools
- Systematic Reviews
Background:
- Diabetic foot complications significantly increase morbidity and mortality.
- Numerous assessment instruments exist, but their measurement properties are often unevaluated.
- Existing systematic reviews on these tools have methodological limitations.
Purpose of the Study:
- To synthesize evidence on diabetic foot assessment tools from systematic reviews.
- To evaluate the methodological quality of these reviews.
- To compare the psychometric properties and clinical applicability of identified tools.
Main Methods:
- An umbrella review methodology was employed, searching major databases for systematic reviews published between 2010 and 2025.
- Risk of Bias in Systematic Reviews (ROBIS) and COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) tools were used for quality assessment.
- Data extraction and analysis focused on psychometric properties and clinical applicability.
Main Results:
- Eleven systematic reviews covering 24 instruments were analyzed.
- A high risk of bias (73%) was found in the included systematic reviews.
- Reliability and construct validity were frequently reported, but measurement error, responsiveness, and cross-cultural validation were seldom assessed.
Conclusions:
- Substantial gaps exist in the psychometric evaluation of diabetic foot assessment tools.
- Methodological flaws in supporting systematic reviews hinder robust conclusions.
- Clinicians must use caution when selecting tools; future research should focus on rigorous validation and high-quality systematic reviews.
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