Does contact with a podiatrist prevent the occurrence of a lower extremity amputation in people with diabetes? A systematic review and meta-analysis

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dc.contributor.author Buckley, Claire M.
dc.contributor.author Perry, Ivan J.
dc.contributor.author Bradley, Colin P.
dc.contributor.author Kearney, Patricia M.
dc.date.accessioned 2014-03-19T15:24:56Z
dc.date.available 2014-03-19T15:24:56Z
dc.date.issued 2013-05-08
dc.identifier.citation BUCKLEY, C. M., PERRY, I. J., BRADLEY, C. P. & KEARNEY, P. M. 2013. Does contact with a podiatrist prevent the occurrence of a lower extremity amputation in people with diabetes? A systematic review and meta-analysis. BMJ Open, 3 (5): e002331 doi: 10.1136/bmjopen-2012-002331 en
dc.identifier.volume 3 en
dc.identifier.issued 5 en
dc.identifier.startpage e002331 en
dc.identifier.issn 2044-6055
dc.identifier.uri http://hdl.handle.net/10468/1472
dc.identifier.doi 10.1136/bmjopen-2012-002331
dc.description.abstract Objective To determine the effect of contact with a podiatrist on the occurrence of Lower Extremity Amputation (LEA) in people with diabetes.Design and data sources We conducted a systematic review of available literature on the effect of contact with a podiatrist on the risk of LEA in people with diabetes. Eligible studies, published in English, were identified through searches of PubMed, CINAHL, EMBASE and Cochrane databases. The key terms, ‘podiatry’, ‘amputation’ and ‘diabetes’, were searched as Medical Subject Heading terms. Reference lists of selected papers were hand-searched for additional articles. No date restrictions were imposed.Study selection Published randomised and analytical observational studies of the effect of contact with a podiatrist on the risk of LEA in people with diabetes were included. Cross-sectional studies, review articles, chart reviews and case series were excluded. Two reviewers independently assessed titles, abstracts and full articles to identify eligible studies and extracted data related to the study design, characteristics of participants, interventions, outcomes, control for confounding factors and risk estimates.Analysis Meta-analysis was performed separately for randomised and non-randomised studies. Relative risks (RRs) with 95% CIs were estimated with fixed and random effects models as appropriate.Results Six studies met the inclusion criteria and five provided data included in meta-analysis. The identified studies were heterogenous in design and included people with diabetes at both low and high risk of amputation. Contact with a podiatrist did not significantly affect the RR of LEA in a meta-analysis of available data from randomised controlled trials (RCTs); (1.41, 95% CI 0.20 to 9.78, 2 RCTs) or from cohort studies; (0.73, 95% CI 0.39 to 1.33, 3 Cohort studies with four substudies in one cohort). Conclusions There are very limited data available on the effect of contact with a podiatrist on the risk of LEA in people with diabetes. en
dc.description.sponsorship Health Research Board (HPF/2009/79) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BMJ Publishing Group en
dc.relation.uri http://bmjopen.bmj.com/content/3/5/e002331
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode en
dc.rights.uri http://creativecommons.org/licenses/by-nc/3.0/ en
dc.subject Lower Extremity Amputation (LEA) en
dc.subject Diabetes en
dc.subject Podiatry en
dc.title Does contact with a podiatrist prevent the occurrence of a lower extremity amputation in people with diabetes? A systematic review and meta-analysis en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Patricia Kearney, Epidemiology & Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: patricia.kearney@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2013-11-28T14:24:23Z
dc.description.version Published Version en
dc.internal.rssid 221089765
dc.internal.pmid 23657467
dc.contributor.funder Health Research Board en
dc.contributor.funder Irish College of General Practitioners Research and Education Foundation en
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMJ Open en
dc.internal.copyrightchecked Yes !!CORA!! CC license. PV permitted en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress patricia.kearney@ucc.ie en


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This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode
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