{"doi":"10.3390/s23094423","title":"The Validity and Reliability of Self-Reported Adherence to Using Offloading Treatment in People with Diabetes-Related Foot Ulcers","abstract":"Adherence to using offloading treatment is crucial to healing diabetes-related foot ulcers (DFUs). Offloading adherence is recommended to be measured using objective monitors. However, self-reported adherence is commonly used and has unknown validity and reliability. This study aimed to assess the validity and reliability of self-reported adherence to using removable cast walker (RCW) offloading treatment among people with DFUs. Fifty-three participants with DFUs using RCWs were included. Each participant self-reported their percentage adherence to using their RCW of total daily steps. Participants also had adherence objectively measured using dual activity monitors. After one week, a subset of 19 participants again self-reported their percentage adherence to investigate test–retest reliability. Validity was tested using Pearson’s r and Bland–Altman tests, and reliability using Cohen’s kappa. Median (IQR) self-reported adherence was greater than objectively measured adherence (90% (60–100) vs. 35% (19–47), p < 0.01). There was fair agreement (r = 0.46; p < 0.01) and large 95% limits of agreement with significant proportional bias (β = 0.46, p < 0.01) for validity, and minimal agreement for test–retest reliability (K = 0.36; p < 0.01). The validity and reliability of self-reported offloading adherence in people with DFU are fair at best. People with DFU significantly overestimate their offloading adherence. Clinicians and researchers should instead use objective adherence measures.","journal":"Sensors","year":2023,"id":358415,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9536,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1108508,"name":"Kathleen Finlayson","orcid":"0000-0002-5743-2731","position":1,"is_corresponding":false},{"id":1108509,"name":"Helen Edwards","orcid":"0000-0002-4451-0577","position":2,"is_corresponding":false},{"id":289127,"name":"David G. Armstrong","orcid":"0000-0003-1887-9175","position":3,"is_corresponding":false},{"id":478542,"name":"Bijan Najafi","orcid":"0000-0002-0320-8101","position":4,"is_corresponding":false},{"id":1108510,"name":"Jaap J. van Netten","orcid":"0000-0002-6420-6046","position":5,"is_corresponding":false},{"id":1108511,"name":"Peter A Lazzarini","orcid":"0000-0002-8235-7964","position":6,"is_corresponding":false},{"id":1108507,"name":"Anas Ababneh","orcid":"0000-0001-8044-3554","position":0,"is_corresponding":true}],"reference_count":54,"raw_metadata":null,"created_at":"2026-07-19T01:13:43.629667Z","pmid":"37177627","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}