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At least 19 recordsLinked to original sources
PubMed1991

Chiropody and the QALY: a case study in assigning categories of disability and distress to patients.

Quality adjusted life years (QALYs) are claimed to be a universal means of measuring output from health care interventions. However, existing QALY research has been carried out mainly in 'high-tech', life extending areas of health care. This paper presents an application of QALY measurement to a 'low-tech' life-quality enhancing area of health care, chiropody. Information on changes in quality of life following chiropody interventions was elicited from both practitioners and patients. We found the apparently low benefit, but low cost service of chiropody to be a potentially cost-effective use of NHS resources. Methodological issues are also addressed relating to the assignment of patients to health states, and whether practitioners' or patients' assessments of changes in quality of life should be used.

Aged↗
PubMed1996

Targeted screening for diabetes in community chiropody clinics.

Population screening for diabetes mellitus is of uncertain value. We therefore assessed the value of screening amongst community chiropody clinic attenders in Liverpool. All attenders aged between 40 and 75 years during a 3-month period were offered screening by urine glucose self-testing, 2 hours post-prandially, backed up with glucose tolerance tests (GTT) for positive respondents. Of 1058 patients screened, 11 (1.0%) reported positive results, of whom four (0.4% of total) had diabetes, and two had impaired glucose tolerance (IGT). Screening costs were 11p per person, 2.06 pounds per 'positive' person, and 34.46 pounds for each newly diagnosed patient. The screening procedure was simple and highly cost-effective, but the diagnostic returns were only moderate. This may have been because of a high rate of known diabetes amongst the chiropody clinic attenders (17.3%). In view of this, routine widespread diabetes screening in chiropody clinics cannot at present be recommended.

Adult↗
PubMedDate not supplied

Reliability of the diagnosis of impairments in survey research in the field of chiropody.

Chiropody is a rather unknown paramedical profession in The Netherlands. A chiropodist treats foot and nail problems or postural deviations which may be corrected by means of remedial foot therapy. There is no history of scientific research on chiropody. A necessary first step is a survey on professional practice, diagnosis and treatment. A requirement for a survey study is a reliable registration form. In this study a registration form that draws on the conceptual framework of the ICIDH (International Classification of Impairments, Disabilities and Handicaps) was tested on inter-observer reliability. A chiropodist and a trainee examined 49 patients. Reliability was determined using two measures: the percentage of agreement and Cohen's Kappa. Findings of this study indicate that the reliability of the registration form for the assessment of the chiropody diagnosis is satisfactory.

Adult↗
PubMedDate not supplied

Chiropody may prevent amputations in diabetic patients on peritoneal dialysis.

BACKGROUND: A multidisciplinary approach has been shown to be of benefit in the prevention of lower limb ulceration and amputation in patients with diabetes, but there is less information on the role of such an approach in patients receiving dialysis treatment. OBJECTIVE: The purpose of the present study was to determine whether the institution of a chiropody program would result in fewer amputations in diabetic patients on peritoneal dialysis (PD). DESIGN: Retrospective chart review. SETTING: The PD program at a tertiary-care hospital. PATIENTS: Patients with diabetes that were enrolled in the PD program between January 1997 and December 1999, inclusive, that were offered the opportunity to see a chiropodist, and that agreed to be seen. A total of 132 patients were included. INTERVENTION: Education about foot care, assessment, and, in some instances, treatment by a chiropodist. RESULTS: Patients with an amputation were more likely to be male (p < 0.01) and have peripheral vascular disease (p < 0.001) compared to those without an amputation. They also had a lower average mean arterial pressure (p < 0.05), lower weekly creatinine clearance (p < 0.01), higher mean erythropoietin dose (p < 0.05), and longer duration of end-stage renal disease (p < 0.001). Factors that were predictive of shorter time to death or amputation were older age [hazard ratio (HR) = 1.03, p < 0.05], peripheral vascular disease (HR = 2.66, p< 0.01), and cerebrovascular disease (HR = 2.70, p< 0.01). Being seen by a chiropodist was protective (HR = 0.39, p < 0.01). CONCLUSION: The current study suggests that a chiropody program may help to prevent amputation in patients with diabetes on PD.

Adult↗
PubMed1968

Studies in the epidemiology of tinea pedis. IX. Tinea pedis and erythrasma in new patients at a chiropody clinic.

The feet of 259 new patients at a chiropody clinic were examined for tinea pedis, onychomycosis, and erythrasma: 23% of men and 4% of women were infected by dermatophytes, and the nails of seven males were infected by non-dermatophytes. Of 200 patients examined under Wood's light 37% showed the coral-red fluorescence of erythrasma.Of the 259 patients, 9.7% were infected by Trichophyton interdigitale, 2.7% by T. rubrum, and 1.5% by Epidermophyton floccosum. Reasons are given, based on the method of selection of the patients, for supposing that T. interdigitale is still the dominant cause of tinea pedis in the population at large, despite figures from dermatological clinics suggesting the dominance of T. rubrum. The high incidence of infection in males compared with females corresponds with similar findings in school-children.

Adult↗