Commentary on: creating a diabetes foot reminder-based registry using the electronic medical record.

The paper byWrobel et al examined the efficacy of an electronic diabetes foot examination registry to aide stratification of patients into ‘risk groups’ and thus guides appropriate care. Convincing data exists to demonstrate that patients can be stratified into groups at higher or lower risk of subsequent ulceration/ amputation. The stratification tools largely rely on detailed examination findings (neuropathy, peripheral artery disease, abnormalities of foot shape). What is less clear is whether these risk stratification schemes can be successfully translated into effective population based screening.