Journal of diabetes science and technology · 2021
Accuracy of Foot Pressure Measurement on Predicting the Development of Foot Ulcer in Patients with Diabetes: A Systematic Review and Meta-Analysis.
МетаанализСистематический обзорСтатьяНазвание и аннотация: Перевод пока не подготовлен
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de Castro João Pedro Wardani, Ferreira Felipe Camargo, Vargas João Gustavo Franco, Bosso Lucas Bressan, Nabozny Nathan, Martins Camila Marinelli, Farhat Gabriel, Gomes Ricardo Zanetti
Аннотация
OBJECTIVE: Areas of the foot with diabetic ulcers have been observed to have greater plantar pressures compared to non-ulcerated. Pressures play an essential role in the mechanism of lesion, and their reduction is effective in prevention. We conducted a systematic review to evaluate pedobarography as a predictive tool for ulcer development, since there is still no consensus on this aspect.
METHODS: We searched PUBMED (MedLine), EMBASE, Scopus, Web of Science, CINAHL and Scielo for cohort studies that measured plantar pressure at baseline and verified ulcer development on follow-up. Pooled effects of accuracy, sensitivity, specificity and relative risk were calculated using the inverse variance method. Risk of bias was assessed using the QUADAS-2 tool.
RESULTS: Three studies (n = 2000) had enough information on accuracy to be included into a meta-analysis, and 4 (n = 2651) were analyzed using qualitative methods. Pooled sensitivity and specificity were found to be 0.63 (Confidence Interval (CI) 0.58-0.68) and 0.42 (CI 0.27-0.58), respectively. Pooled relative risk was 1.95 (CI 1.09-3.51). Risk of bias was low to uncertain.
CONCLUSIONS: Pedobarography in itself appears to have low accuracy in evaluating risk of ulceration. Several methodological heterogeneities were found, and the most optimal cut-off value is yet to be determined.
METHODS: We searched PUBMED (MedLine), EMBASE, Scopus, Web of Science, CINAHL and Scielo for cohort studies that measured plantar pressure at baseline and verified ulcer development on follow-up. Pooled effects of accuracy, sensitivity, specificity and relative risk were calculated using the inverse variance method. Risk of bias was assessed using the QUADAS-2 tool.
RESULTS: Three studies (n = 2000) had enough information on accuracy to be included into a meta-analysis, and 4 (n = 2651) were analyzed using qualitative methods. Pooled sensitivity and specificity were found to be 0.63 (Confidence Interval (CI) 0.58-0.68) and 0.42 (CI 0.27-0.58), respectively. Pooled relative risk was 1.95 (CI 1.09-3.51). Risk of bias was low to uncertain.
CONCLUSIONS: Pedobarography in itself appears to have low accuracy in evaluating risk of ulceration. Several methodological heterogeneities were found, and the most optimal cut-off value is yet to be determined.