{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T07:32:56Z","timestamp":1771918376613,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T00:00:00Z","timestamp":1681516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72204277"],"award-info":[{"award-number":["72204277"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims\/Introduction<\/jats:title><jats:p>The purpose of the present study was to evaluate the validation and application of the 2019 International Working Group on the Diabetic Foot (IWGDF) risk stratification system among Chinese patients with diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A retrospective cohort study was carried out with 254 patients with diabetes, but without an active diabetic foot (DF) ulcer. Patients hospitalized from January to May 2017 were enrolled, and the follow\u2010up period was from January to May 2020. Patients were stratified into four risk groups based on the 2019 IWGDF risk stratification system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 254 patients, four of 31 patients at risk 1 were diagnosed with DF within 3\u2009years, whereas 12 of 26 patients at risk 2 and 16 of 20 patients at risk 3 developed DF. The area under the curve was 0.919 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01, 95% confidence interval 0.893\u20130.945). Because DF risk 2 and greater (risk 2\u2009+\u2009risk 3) was the optimal cut\u2010off point, we simplified the risk stratification system by using two tiers, namely, low risk (risk 0\u2009+\u20091) and high risk (risk 2\u2009+\u20093). For the simplified risk stratification system, the sensitivity, specificity, positive likelihood ratio, percent agreement, positive predictive value and negative predictive value were 87.5%, 91.8%, 10.607, 91.3%, 60.8% and 98.1%, respectively. The \u03c7<jats:sup>2<\/jats:sup>\u2010test showed that the odds ratio of the high\u2010risk group (risk 2\u2009+\u20093) was 29.33\u2010fold that of the low\u2010risk group (risk 0\u2009+\u20091).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The 2019 IWGDF risk stratification system showed high validity and primary screening value in Chinese patients with diabetes. Thus, a simplified, two\u2010tiered IWGDF stratification might be more efficient and cost\u2010effective for predicting DF ulcers.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.14014","type":"journal-article","created":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T18:28:40Z","timestamp":1681583320000},"page":"893-901","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Validation and application of the 2019 International Working Group on the Diabetic Foot risk stratification for diabetic foot in Chinese patients"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7888-2267","authenticated-orcid":false,"given":"Xiling","family":"Hu","sequence":"first","affiliation":[{"name":"School of Nursing Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism The Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Diabetology The Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1648-548X","authenticated-orcid":false,"given":"Yanming","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism The Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Diabetology The Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin\u2010Ping","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Nursing Xi'an Jiaotong University Health Science Center  Xi'an China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2019.107843"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3101"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00618-8"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3266"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67698-2"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2017.04.013"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.2.217"},{"key":"e_1_2_7_9_1","first-page":"18","article-title":"Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update)","volume":"36","author":"Bus SA","year":"2020","journal-title":"Diabetes Metab Res Rev"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.8.1442"},{"key":"e_1_2_7_12_1","first-page":"22","article-title":"Prevention of foot ulcers in the at\u2010risk patient with diabetes: A systematic review","volume":"36","author":"Van Netten JJ","year":"2020","journal-title":"Diabetes Metab Res Rev"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-12-0279"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2017.02.034"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(16)00051-6"},{"key":"e_1_2_7_16_1","first-page":"92","article-title":"Guidelines for prevention and treatment of diabetes feet in China (2019 edition) (I)","volume":"11","author":"Chinese Diabetes Society, Chinese Society of Infectious Diseases, Chinese Society for Tissue Repair and Regeneration","year":"2019","journal-title":"Chin J Diabetes"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12263"},{"key":"e_1_2_7_18_1","first-page":"496","article-title":"A multicenter survey on the diabetic foot and medical economics in China","volume":"6","author":"Wang A","year":"2005","journal-title":"Chin J Endocrinol Metab"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-2176"},{"key":"e_1_2_7_20_1","first-page":"499","article-title":"Comparison of clinical characteristics and medical costs of patients with diabetic foot ulcer between 2004 and 2012 in China","volume":"6","author":"Ban Y","year":"2014","journal-title":"Chin J Diabetes Mellit"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.293.3473"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1368-5031.2006.00899.x"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2011.03297.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2016.1231932"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12642"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-1302"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc05-2031"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2012.02.004"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2319"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hct182"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-018-0270-2"}],"container-title":["Journal of Diabetes Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdi.14014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T16:12:35Z","timestamp":1692461555000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdi.14014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,15]]},"references-count":30,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1111\/jdi.14014"],"URL":"https:\/\/doi.org\/10.1111\/jdi.14014","archive":["Portico"],"relation":{},"ISSN":["2040-1116","2040-1124"],"issn-type":[{"value":"2040-1116","type":"print"},{"value":"2040-1124","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,15]]},"assertion":[{"value":"2022-10-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}