The 10-year follow-up of a community-based cohort of people with diabetes: The incidence of foot ulceration and death.

Background: Identifying people with diabetes who are likely to experience a foot ulcer is an important part of preventative care. Many cohort studies report predictive models for foot ulcerations and for people with diabetes, but reports of long-term outcomes are scarce.

Aim: We aimed to develop a predictive model for foot ulceration in diabetes using a range of potential risk factors with a follow-up of 10 years after recruitment.

Reliability of the evidence to guide decision-making in foot ulcer prevention in diabetes: an overview of systematic reviews.

Background: Reliable evidence on the effectiveness of interventions to prevent diabetes-related foot ulceration is essential to inform clinical practice. Well-conducted systematic reviews that synthesise evidence from all relevant trials offer the most robust evidence for decision-making. We conducted an overview to assess the comprehensiveness and utility of the available secondary evidence as a reliable source of robust estimates of effect with the aim of informing a cost-effective care pathway using an economic model.

Development and validation of a clinical prediction rule for development of diabetic foot ulceration: an analysis of data from five cohort studies.

Introduction: The aim of the study was to develop and validate a clinical prediction rule (CPR) for foot ulceration in people with diabetes.

Research Design And Methods: Development of a CPR using individual participant data from four international cohort studies identified by systematic review, with validation in a fifth study. Development cohorts were from primary and secondary care foot clinics in Europe and the USA (n=8255, adults over 18 years old, with diabetes, ulcer free at recruitment).

Risk assessments and structured care interventions for prevention of foot ulceration in diabetes: development and validation of a prognostic model.

Background: Diabetes-related foot ulcers give rise to considerable morbidity, generate a high monetary cost for health and social care services and precede the majority of diabetes-related lower extremity amputations. There are many clinical prediction rules in existence to assess risk of foot ulceration but few have been subject to validation.

Objectives: Our objectives were to produce an evidence-based clinical pathway for risk assessment and management of the foot in people with diabetes mellitus to estimate cost-effective monitoring intervals and to perform cost-effectiveness analyses and a value-of-information analysis.

Preventing foot ulceration in diabetes: systematic review and meta-analyses of RCT data.

Aims/hypothesis: Foot ulceration is a serious complication for people with diabetes that results in high levels of morbidity for individuals and significant costs for health and social care systems. Nineteen systematic reviews of preventative interventions have been published, but none provides a reliable numerical summary of treatment effects. The aim of this study was to systematically review the evidence from RCTs and, where possible, conduct meta-analyses to make the best possible use of the currently available data.

The use of fibrin sealant during non-emergency surgery: a systematic review of evidence of benefits and harms.

Background: Fibrin sealants are used in different types of surgery to prevent the accumulation of post-operative fluid (seroma) or blood (haematoma) or to arrest haemorrhage (bleeding). However, there is uncertainty around the benefits and harms of fibrin sealant use.

Objectives: To systematically review the evidence on the benefits and harms of fibrin sealants in non-emergency surgery in adults.

Ankle brachial index for the diagnosis of lower limb peripheral arterial disease.

Background: Peripheral arterial disease (PAD) of the lower limb is common, with prevalence of both symptomatic and asymptomatic disease estimated at 13% in the over 50 age group. Symptomatic PAD affects about 5% of individuals in Western populations between the ages of 55 and 74 years. The most common initial symptom of PAD is muscle pain on exercise that is relieved by rest and is attributed to reduced lower limb blood flow due to atherosclerotic disease (intermittent claudication).

D-dimer test for excluding the diagnosis of pulmonary embolism.

Background: Pulmonary embolism (PE) can occur when a thrombus (blood clot) travels through the veins and lodges in the arteries of the lungs, producing an obstruction. People who are thought to be at risk include those with cancer, people who have had a recent surgical procedure or have experienced long periods of immobilisation and women who are pregnant. The clinical presentation can vary, but unexplained respiratory symptoms such as difficulty breathing, chest pain and an increased respiratory rate are common.

A systematic review and individual patient data meta-analysis of prognostic factors for foot ulceration in people with diabetes: the international research collaboration for the prediction of diabetic foot ulcerations (PODUS).

Background: Annual foot risk assessment of people with diabetes is recommended in national and international clinical guidelines. At present, these are consensus based and use only a proportion of the available evidence.

Objectives: We undertook a systematic review of individual patient data (IPD) to identify the most highly prognostic factors for foot ulceration (i.

The impact of official development aid on maternal and reproductive health outcomes: a systematic review.

Background: Progress toward meeting Millennium Development Goal 5, which aims to improve maternal and reproductive health outcomes, is behind schedule. This is despite ever increasing volumes of official development aid targeting the goal, calling into question the distribution and efficacy of aid. The 2005 Paris Declaration on Aid Effectiveness represented a global commitment to reform aid practices in order to improve development outcomes, encouraging a shift toward collaborative aid arrangements which support the national plans of aid recipient countries (and discouraging unaligned donor projects).

Protocol for a systematic review and individual patient data meta-analysis of prognostic factors of foot ulceration in people with diabetes: the international research collaboration for the prediction of diabetic foot ulcerations (PODUS).

Background: Diabetes-related lower limb amputations are associated with considerable morbidity and mortality and are usually preceded by foot ulceration. The available systematic reviews of aggregate data are compromised because the primary studies report both adjusted and unadjusted estimates. As adjusted meta-analyses of aggregate data can be challenging, the best way to standardise the analytical approach is to conduct a meta-analysis based on individual patient data (IPD).

Vitamin K antagonists or low-molecular-weight heparin for the long term treatment of symptomatic venous thromboembolism.

Background: People with venous thromboembolism (VTE) are generally treated for five days with intravenous unfractionated heparin or subcutaneous low-molecular-weight heparin (LMWH) followed by three months of vitamin K antagonist treatment. Treatment with vitamin K antagonists requires regular laboratory measurements and some patients have contraindications to treatment. This is an update of a review first published in 2000 and updated in 2002.

Handsearching did not yield additional unique FDG-PET diagnostic test accuracy studies compared with electronic searches: a preliminary investigation.

We explored the value of handsearching to identify diagnostic test accuracy (DTA) studies to inform systematic reviews of DTA. Handsearching was conducted alongside a systematic review of the DTA of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) for colorectal cancer. Ten journals, identified by frequency analysis of studies from six imaging reviews, were handsearched for reports of DTA studies.

WITHDRAWN. Interventions for treating plantar heel pain.

Background: Ten percent of people may experience pain under the heel (plantar heel pain) at some time. Injections, insoles, heel pads, strapping and surgery have been common forms of treatment offered. The absolute and relative effectiveness of these interventions are poorly understood.

General practitioners' and nurses' experiences of using computerised decision support in screening for diabetic foot disease: implementing Scottish Clinical Information - Diabetes Care in routine clinical practice.

Objective: The Scottish Care Information - Diabetes Collaboration (SCI-DC) developed a computer-based information system to create a shared electronic record for use by all involved in the care of patients with diabetes mellitus. The objectives of this study were to understand primary care practitioners' views towards screening for diabetic foot disease and their experience of the SCI-DC system.

Method: We conducted an exploratory study using qualitative methods.

Athlete's foot.

Introduction: Around 15% to 25% of people are likely to have athlete's foot at any one time. The infection can spread to other parts of the body and to other people.

Methods And Outcomes: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of topical treatments for athlete's foot? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review).

Athlete's foot.

Introduction: Around 15-25% of people are likely to have athlete's foot at any one time. The infection can spread to other parts of the body and to other people.

Methods And Outcomes: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of topical treatments for athlete's foot? We searched: Medline, Embase, The Cochrane Library and other important databases up to April 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review).

The effectiveness of extra corporeal shock wave therapy for plantar heel pain: a systematic review and meta-analysis.

Background: There is considerable controversy regarding the effectiveness of extracorporeal shock wave therapy in the management of plantar heel pain. Our aim was to conduct a systematic review of randomised controlled trials to investigate the effectiveness of extracorporeal shock wave therapy and to produce a precise estimate of the likely benefits of this therapy.

Methods: We conducted a systematic review of all randomised controlled trials (RCTs) identified from the Cochrane Controlled trials register, MEDLINE, EMBASE and CINAHL from 1966 until September 2004.