Impaired tactical sensory perception in people with diabetes mellitus

assessing the interevaluators agreement

Abstract

Introduction: impaired tactile sensory perception is a complication of diabetes
mellitus which predates the neuropathy and can be identified by the nurse. It
should involve neurological examination of the feet, evaluation of the sensitivity
(tactile, pain-thermal and vibratory) and tendinous reflexes. Evaluators should
be able to implement the evaluations. For this, training is necessary. Purpose:
To establish the degree of interevaluator agreement in the assessment of altered
tactile sensory perception in patients with diabetes mellitus. Methods: A crosssectional
study was carried out with three evaluators to obtain agreement on the
assessment of the feet of patients with diabetes at a referral outpatient clinic in
Campina Grande, Paraíba, Brazil. A total of 60 lower limbs ( feet) of 30 patients
were evaluated from the protective, thermal, vibration, pain and Achilles reflex.
For the evaluation of inter-rater agreement, the Kappa coefficient was used and
the level of significance was adopted with p <0.05. Results: most patients were
female, with a mean age of 59.3 years old, diagnosis time of 12.6 years. Overall
agreement was observed, with a variation in Kappa coefficient between 0.814
and 0.902 among the gold-standard evaluators. The index obtained indicate near perfect agreement. Conclusion: the evaluators were considered fit
to perform the neurological evaluation of the feet of patients with
diabetes mellitus after a training period. Inter-rater agreement is
critical for clinical research, as it favors the fit between assessments
in different techniques for collecting clinical information.