Measure titleFoot ExamMeasure IDFED_DRP
Description

The percentage of patients 18–75 years of age with diabetes who received a foot exam (neurological, vascular, and visual assessment) during the measurement period.

Measurement period.
Copyright and disclaimer notice

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Clinical recommendation statement

American Diabetes Association (2022)

  • Perform a comprehensive foot evaluation at least annually to identify risk factors for ulcers and amputations. Level of evidence: B
  • Patients with evidence of sensory loss or prior ulceration or amputation should have their feet inspected at every visit. Level of evidence: B
  • The examination should include inspection of the skin, assessment of foot deformities, neurological assessment (10-g monofilament testing with at least one other assessment: pinprick, temperature, vibration), and vascular assessment, including pulses in the legs and feet. Level of evidence: B

Society for Vascular Surgery and American Podiatric Medical Association and Society for Vascular Medicine (2016)

  • We recommend that patients with diabetes undergo annual interval foot inspections by physicians (MD, DO, DPM) or advanced practice providers with training in foot care. Grade: 1C.
  • We recommend that foot examination include testing for peripheral neuropathy using the Semmes-Weinstein test. Grade: 1B.
Citations

American Diabetes Association Professional Practice Committee. 12. Retinopathy, Neuropathy, and Foot Care—2022. Diabetes Care 2022;45(1), 185–194, https://doi.org/10.2337/dc22-S012

Society for Vascular Surgery. Hingorani, A., LaMuraglia, G. M., Henke, P., Meissner, M. H., Loretz, L., Zinszer, K. M., Driver, V. R., Frykberg, R., Carman, T. L., Marston, W., Mills, J. L., & Murad, M. H. (2016). The management of diabetic foot: A clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine. Journal of Vascular Surgery, 63(2), 3S-21S. https://doi.org/10.1016/j.jvs.2015.10.003

Characteristics
ScoringProportion.
TypeProcess.
Stratification
None.
Risk adjustmentNone.
Improvement notationA higher rate indicates better performance.
Guidance

[TBD BY MEASURE TEAM]

Definitions
Initial population

Patients 18-75 years of age by the end of the measurement period who had a visit during the measurement period, and a diagnosis of diabetes that is ongoing or starts during the first six months of the measurement period.

Exclusions

  • Patients in hospice or using hospice services any time during the measurement period.
  • Patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period.
  • Patients 66 and older by the end of the measurement period, with frailty and advanced illness.
  • Patients receiving palliative care during the measurement period.
  • Patients who have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period.

Denominator

The initial population, minus exclusions.

Numerator

Patients who received the following foot assessments during the measurement period:

  • Neurological assessment: 10-g monofilament testing AND at least one other assessment: pinprick, vibration, or ankle reflexes.
  • Vascular assessment: Pedal pulse exam.
  • Visual assessment: Inspection of the skin AND assessment of foot deformities and ulcers.

Data criteria (element level)

Table of Contents

  1. Definitions
  2. Functions

Definitions

Functions