Pallin Jennifer A, McIntosh Caroline, Kavanagh Paul, Dinneen Sean F, Kearney Patricia M, Buckley Claire M
School of Public Health, University College Cork, Cork City, Cork, T12 XF62, Ireland.
Discipline of Podiatric Medicine, National University of Ireland, Galway, Galway City, Galway, H91 TK33, Ireland.
HRB Open Res. 2022 Jul 11;5:50. doi: 10.12688/hrbopenres.13585.1. eCollection 2022.
: Diabetic foot ulcers are one of the most common lower extremity complications of diabetes, with the lifetime risk of a person developing a DFU estimated to be as high as 34%. It is recommended that those with diabetes receive an annual review of their feet, by a trained healthcare professional, to identify risk factors for ulceration and allow for subsequent risk stratification, patient education and provision of appropriate care to prevent ulceration and amputation. Internationally, while many countries have a diabetic foot care pathway, it is not a structured population health screening programme unlike other areas of preventive care for people with diabetes such as retinopathy screening. A structured diabetic foot screening pathway could allow for earlier identification of the at-risk foot. However, the introduction of any population screening programme should meet the Wilson and Jungner principles of screening. This paper presents a protocol for a scoping review of existing evidence on screening for the at-risk-foot against the Wilson and Junger principles. The scoping review will be conducted in line with the six-stage methodological framework by Arksey & O'Mally and the Joanna Briggs Institute (JBI) scoping review methodology. Medline (EBSCO), Scopus, ScienceDirect and EMBASE databases will be searched. Studies relating to the burden of diabetic foot ulcers, their pathophysiology and screening tests for peripheral neuropathy and peripheral artery disease, and screening programmes will be included. A data extraction tool will be used to facilitate a chronological narrative synthesis of results. These will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR). This scoping review will evaluate and map the evidence surrounding diabetic foot ulcers using the Wilson and Jungner principles of screening as a framework.
糖尿病足溃疡是糖尿病最常见的下肢并发症之一,据估计,一个人一生中发生糖尿病足溃疡的风险高达34%。建议糖尿病患者每年由经过培训的医疗保健专业人员对其足部进行检查,以识别溃疡的风险因素,并进行后续的风险分层、患者教育以及提供适当的护理,以预防溃疡和截肢。在国际上,虽然许多国家都有糖尿病足护理路径,但与糖尿病患者的其他预防性护理领域(如视网膜病变筛查)不同,它不是一个结构化的人群健康筛查项目。结构化的糖尿病足筛查路径可以更早地识别出有风险的足部。然而,任何人群筛查项目的引入都应符合威尔逊和荣格纳的筛查原则。本文提出了一项方案,用于对现有关于根据威尔逊和荣格纳原则筛查有风险足部的证据进行范围综述。范围综述将按照阿克斯西和奥马利的六阶段方法框架以及乔安娜·布里格斯研究所(JBI)的范围综述方法进行。将检索医学期刊数据库(EBSCO)、Scopus、ScienceDirect和EMBASE数据库。将纳入与糖尿病足溃疡负担、其病理生理学以及周围神经病变和外周动脉疾病的筛查测试及筛查项目相关的研究。将使用数据提取工具促进按时间顺序对结果进行叙述性综合。这些结果将按照《系统评价和元分析扩展的范围综述首选报告项目》(PRISMA-ScR)进行报告。本范围综述将以威尔逊和荣格纳的筛查原则为框架,评估和梳理围绕糖尿病足溃疡的证据。