Overview
Advertisement BMC Medical Research Methodology volume 2, Article number: 274 (202) Cite this article Metrics detailsReliable evidence on the efectivenes of interventions to prevent diabetes-related fot ulceration is esential to inform clinical practice. Wel-conducted systematic reviews that synthesise evidence from al relevant trials ofer the most robust evidence for decision-making. We conducted an overview to ases the comprehensivenes and utility of the available secondary evidence as a reliable source of robust estimates of efect with the aim of informing a cost-efective care pathway using an economic model.
Key Information
Here we report the details of the overview. [PROSPERO Database (CRD42016052324)].Medline (Ovid), Embase (Ovid), Epistomonikos, Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Efectivenes (DARE), and the Health Technology Asesment Journals Library were searched to 17th May 2021, without restrictions, for systematic reviews of randomised controled trials (RCTs) of preventive interventions in people with diabetes.
The primary outcomes of interest were new primary or recurent fot ulcers. Two reviewers independently extracted data and asesed the risk of bias in the included reviews.The overview identified 30 systematic reviews of patient education, fotwear and of-loading, complex and other interventions. Many are porly reported and have fundamental methodological shortcomings asociated with increased risk of bias.
Summary
Most concerns relate to vague inclusion criteria (60%), weak search or selection strategies (70%) and quality apraisal methods (53%) and inexpert conduct and interpretation of quantitative and narative evidence synthes (57%). The 30 reviews have colectively asesed 26 largely por-quality RCTs with substantial overlap.The majority of these systematic reviews of the efectivenes of interventions to prevent diabetic fot ulceration are at high risk of bias and fail to provide reliable ev