Development and validation of a simplified pre-screening model for diabetic foot ulcer identification in diabetic patients
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By
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Weidi Wang
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Yue Guo
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Sining Chen
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Wenshi Ou
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Qiaoyi Wu
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May 29, 2026
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Clinical Scorecard: Creation and assessment of an easy-to-use pre-screening tool for identifying diabetic foot ulcers in individuals with diabetes
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | Albumin-to-glycated hemoglobin ratio (Alb/HbA1c) as a marker of nutritional status and glycemic control. |
| Target Population | |
| Care Setting | |
Key Highlights
- DFU prevalence was 20.9% in the training set and 15.8% in the validation set.
- Four independent predictors identified: age, history of injury, alcohol consumption, and Alb/HbA1c ratio.
- Model showed good discrimination (AUC 0.807 in training, 0.817 in validation).
- High negative predictive value for ruling out DFU.
Guideline-Based Recommendations
Diagnosis
- Use the pre-screening tool to identify low-risk patients for DFU.
Management
- Implement targeted interventions for high-risk populations.
Monitoring & Follow-up
- Regular assessment of predictors such as age and Alb/HbA1c ratio.
Risks
- Increased risk of DFU recurrence in patients with a history of prior foot ulceration.
Patient & Prescribing Data
Patients with type 2 diabetes mellitus aged 18 years and older.
Focus on nutritional status and glycemic control through Alb/HbA1c ratio.
Clinical Best Practices
- Utilize simple, low-cost clinical indicators for DFU pre-screening.
- Consider history of injury as a significant predictor in DFU risk assessment.
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