What is the incidence of diabetic foot disease in Australia?
What is the prevalence of diabetic foot disease in Australia?
What is the incidence of diabetes related amputations in Australia?
What is the prevalence of diabetes related amputations in Australia?
The following databases will be searched: PubMed and Excerpta Medica Database (EMBASE) via Ovid SP. No restrictions are applied.
Before performing the systematic search of the literature, a validation set of approximately 10 publications was created. Each publication in the set needed to be identified in the literature search. The validation set was created by including key publications known to the authors that fit the scope of this systematic review.
A forward literature search will be performed after selection of the final articles via Google Scholar.
A grey literature search will be undertaken via Google and known datasets.
Types of study to be included
No restrictions are placed on design.
Only population based studies will be included. Population based is defined as any study across broad (regional or national) with well-defined numerator, denominator and populations, and with numbers or percentages of key characteristics within this population presented. Data from single or selected centres will not be considered reflective of the general population and will therefore be excluded.
Condition or domain being studied
Diabetic foot disease is a complication of diabetes associated with major morbidity, mortality, costs and reduction of a person’s quality of life. Diabetic foot ulcers are also the most important precursor for lower extremity amputations in people with diabetes.
As primary outcome, studies reporting Australian population-based incidence or prevalence of diabetic foot disease or diabetes-related lower extremity amputation are included.
Studies reporting data on any Australian region or the entire country will be included.
Diabetic foot disease or diabetes-related amputation incidence and prevalence
In-hospital incidence or prevalence of diabetic foot disease or diabetes-related lower extremity amputation
Data extraction, (selection and coding)
Title and abstract will be screened by two independent investigators for inclusion of publication. Cohen’s kappa will be calculated for agreement [ref]. Criterion for inclusion for full-text assessment is any mentioning of epidemiological data on diabetic foot disease or lower-extremity amputation in an Australian setting. A publication indicated to be included by either one of the investigators will be included for full-text assessment. Full-text articles will be screened by two independent investigators for assessment of inclusion and exclusion criteria as described above. Disagreements between investigators will be solved with discussion until consensus is reached, with a third investigator to be involved when needed.
Risk of bias (quality) assessment
As no specific quality assessment instrument is suited to the data and research aim, a self-developed approach will be followed. In line with conclusions from a systematic review on tools for assessing the quality and susceptibility to bias in observational studies, a transparent checklist approach is chosen, concentrating on the few, principal, potential sources of bias. The self-developed checklist is based on a checklist used for a systematic review on population-based studies investigating mortality after amputation, which in turn was based broadly on the MOOSE guidelines and the Newcastle-Ottawa scale, and aimed to assess selection and information bias.
Five criteria will be assessed by two independent investigators (Table 2). Each criterion is scored with a “+,” “?,” or “-”. Disagreements will be resolved by discussion until consensus is reached, with a third investigator to be involved if needed. The criteria chosen are based primarily on the completeness of the population included, known to be an important aspect of bias in amputation research, and included the method of identifying information and the description of the population.
Authors will not assess the quality of a study of which they were (co-)author.
Strategy for data synthesis
Data will be synthesized in tables. Meta-analysis is not expected to be feasible.
Analysis of subgroups or subsets
Results will be published in a peer-reviewed journal and communicated via the channels of Diabetic Foot Australia, including the DFA conference
Contact details for further information
Dr van Netten
Queensland University of Technology
School of Clinical Sciences
Faculty of Health
Victoria Park Road
Kelvin Grove QLD 4059
Organisational affiliation of the review
Dr Jaap van Netten, Ms Mendel Baba, South Metropolitan Health Service Mr Peter Lazzarini, Queensland University of Technology
Formal screening of search results against eligibility criteria
Risk of bias (quality) assessment
PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites.