Structured Education Improves Radiographic Detection and Referral in Charcot Foot: A Quasi-experimental Study.

Background: Charcot foot, characterized by progressive osseous and articular destruction, necessitates early diagnosis and a multidisciplinary approach to prevent severe complications. This study assessed the efficacy of an educational intervention in improving radiographic detection and referral for Charcot foot among health care professionals. Methods: Thirty health care professionals, including foot and ankle surgeons (FAs), orthopaedic/trauma specialists (OTs), and family physicians (FDs), participated in this quasi-experimental, pre-post study. Participants completed a baseline assessment and received an educational intervention (face-to-face/webinar or self-directed PDF), followed by a reassessment. Primary outcomes included changes in diagnostic and referral accuracy, evaluated through score improvements and Fleiss κ for interobserver agreement. Reliability in the Meary angle measurement was also assessed. Results: FA specialists demonstrated consistently high baseline scores. Following the intervention, OT and FD groups exhibited significant improvements in both diagnostic and referral scores. Fleiss κ increased from 0.463 to 0.700 for OT diagnosis, and from 0.439 to 0.723 for referral. Fleiss κ values for FD improved from 0.352 to 0.546 for diagnosis and from 0.071 to 0.608 for referral. Face-to-face/webinar training outperformed the PDF format, yielding higher scores and agreement rates. Interobserver reliability for the Meary angle was excellent (intraclass correlation coefficient = 0.988). Conclusion: Structured educational interventions significantly enhanced clinicians' ability to diagnose and appropriately refer patients with Charcot foot. Face-to-face instruction proved more effective than self-directed formats. Level of Evidence: Level III, quasi-experimental pre-post study.