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Clinical photographic observation of plantar corns and callus associated with a nominal scale classification and inter‐ observer reliability study in a student population

Overview of attention for article published in Journal of Foot and Ankle Research, October 2017
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Title
Clinical photographic observation of plantar corns and callus associated with a nominal scale classification and inter‐ observer reliability study in a student population
Published in
Journal of Foot and Ankle Research, October 2017
DOI 10.1186/s13047-017-0225-2
Pubmed ID
Authors

David R. Tollafield

Abstract

The management of plantar corns and callus has a low cost-benefit with reduced prioritisation in healthcare. The distinction between types of keratin lesions that forms corns and callus has attracted limited interest. Observation is imperative to improving diagnostic predictions and a number of studies point to some confusion as to how best to achieve this. The use of photographic observation has been proposed to improve our understanding of intractable keratin lesions. Students from a podiatry school reviewed photographs where plantar keratin lesions were divided into four nominal groups; light callus (Grade 1), heavy defined callus (Grade 2), concentric keratin plugs (Grade 3) and callus with deeper density changes under the forefoot (Grade 4). A group of 'experts' assigned from qualified podiatrists validated the observer rated responses by the students. Cohen's weighted statistic (k) was used to measure inter-observer reliability. First year students (unskilled) performed less well when viewing photographs (k = 0.33) compared to third year students (semi-skilled, k = 0.62). The experts performed better than students (k = 0.88) providing consistency with wound care models in other studies. Improved clinical annotation of clinical features, supported by classification of keratin- based lesions, combined with patient outcome tools, could improve the scientific rationale to prioritise patient care. Problems associated with photographic assessment involves trying to differentiate similar lesions without the benefit of direct palpation. Direct observation of callus with and without debridement requires further investigation alongside the model proposed in this paper.

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The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 34 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 7 21%
Student > Doctoral Student 4 12%
Student > Master 3 9%
Student > Postgraduate 3 9%
Student > Ph. D. Student 2 6%
Other 3 9%
Unknown 12 35%
Readers by discipline Count As %
Medicine and Dentistry 10 29%
Nursing and Health Professions 3 9%
Agricultural and Biological Sciences 3 9%
Arts and Humanities 2 6%
Business, Management and Accounting 1 3%
Other 2 6%
Unknown 13 38%