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Is an increase in skin temperature predictive of neuropathic foot ulceration in people with diabetes? A systematic review and meta-analysis.

Houghton VJ, Bower VM, Chant DC - J Foot Ankle Res (2013)

Bottom Line: The theory that there is a mean norm foot temperature which can be used as a benchmark to monitor pathological change was unsupported by this meta-analysis.The conclusions derived from this review are based on the best available scientific evidence in this field.Based on quality studies in this area, the results of this review have indicated that the use of temperature-monitoring is an effective way to predict, and thus prevent, diabetic foot ulceration.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Surgery, University of Western Australia, Perth, Australia. virginia.bower@uwa.edu.au.

ABSTRACT

Introduction: The aim of this systematic review was to evaluate the strength of the existing research to answer the question: Is an increase in skin temperature predictive of neuropathic foot ulceration in people with diabetes?

Methods: This study is a systematic review and meta-analysis of temperature-monitoring in the prediction and prevention of diabetic foot ulceration. Two investigators conducted a literature search for all relevant articles from 1960 until July 2011. During this process the following data bases were searched: MEDLINE, Science Direct, AMED, Australian Medical Index, APAIS-Health, ATSIhealth, EMBASE, Web of Science and OneSearch. Keywords used in this search included diabetes, foot complications, ulceration, temperature-monitoring, prediction and prevention.

Results: Results of the meta-analysis support the theory that an increase in skin temperature is predictive of foot ulceration when compared with the same site on the contralateral limb. The theory that there is a mean norm foot temperature which can be used as a benchmark to monitor pathological change was unsupported by this meta-analysis.

Conclusions: The conclusions derived from this review are based on the best available scientific evidence in this field. It is intended that the results of this study will improve clinical decision-making and encourage the appropriate measures used to predict and prevent ulceration in people with diabetes at high risk of foot complications. Based on quality studies in this area, the results of this review have indicated that the use of temperature-monitoring is an effective way to predict, and thus prevent, diabetic foot ulceration.

No MeSH data available.


Related in: MedlinePlus

Random effects meta-analysis of three odds ratios (Lavery 2004 omitted) and forest plot of observed odds ratios and 95% confidence intervals for the prevention studies (Lavery 2004 omitted).
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Figure 5: Random effects meta-analysis of three odds ratios (Lavery 2004 omitted) and forest plot of observed odds ratios and 95% confidence intervals for the prevention studies (Lavery 2004 omitted).

Mentions: Meta-analysis of these three articles combined concluded a summary effect of 3.80 with a 95% confidence interval. The wider confidence interval of Lavery 2004 contributes much less weight to the summary effect of 3.80 than the other three odds-ratios analysed in this meta-analysis. This is made even clearer in FigureĀ 5, in which Lavery 2004 is omitted, and the summary effect only drops to 3.73. The odds ratio being greater than one in this meta-analysis, thus indicates, that subjects who participated in the daily monitoring of their foot temperatures were at a lesser risk of developing ulceration.


Is an increase in skin temperature predictive of neuropathic foot ulceration in people with diabetes? A systematic review and meta-analysis.

Houghton VJ, Bower VM, Chant DC - J Foot Ankle Res (2013)

Random effects meta-analysis of three odds ratios (Lavery 2004 omitted) and forest plot of observed odds ratios and 95% confidence intervals for the prevention studies (Lavery 2004 omitted).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750703&req=5

Figure 5: Random effects meta-analysis of three odds ratios (Lavery 2004 omitted) and forest plot of observed odds ratios and 95% confidence intervals for the prevention studies (Lavery 2004 omitted).
Mentions: Meta-analysis of these three articles combined concluded a summary effect of 3.80 with a 95% confidence interval. The wider confidence interval of Lavery 2004 contributes much less weight to the summary effect of 3.80 than the other three odds-ratios analysed in this meta-analysis. This is made even clearer in FigureĀ 5, in which Lavery 2004 is omitted, and the summary effect only drops to 3.73. The odds ratio being greater than one in this meta-analysis, thus indicates, that subjects who participated in the daily monitoring of their foot temperatures were at a lesser risk of developing ulceration.

Bottom Line: The theory that there is a mean norm foot temperature which can be used as a benchmark to monitor pathological change was unsupported by this meta-analysis.The conclusions derived from this review are based on the best available scientific evidence in this field.Based on quality studies in this area, the results of this review have indicated that the use of temperature-monitoring is an effective way to predict, and thus prevent, diabetic foot ulceration.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Surgery, University of Western Australia, Perth, Australia. virginia.bower@uwa.edu.au.

ABSTRACT

Introduction: The aim of this systematic review was to evaluate the strength of the existing research to answer the question: Is an increase in skin temperature predictive of neuropathic foot ulceration in people with diabetes?

Methods: This study is a systematic review and meta-analysis of temperature-monitoring in the prediction and prevention of diabetic foot ulceration. Two investigators conducted a literature search for all relevant articles from 1960 until July 2011. During this process the following data bases were searched: MEDLINE, Science Direct, AMED, Australian Medical Index, APAIS-Health, ATSIhealth, EMBASE, Web of Science and OneSearch. Keywords used in this search included diabetes, foot complications, ulceration, temperature-monitoring, prediction and prevention.

Results: Results of the meta-analysis support the theory that an increase in skin temperature is predictive of foot ulceration when compared with the same site on the contralateral limb. The theory that there is a mean norm foot temperature which can be used as a benchmark to monitor pathological change was unsupported by this meta-analysis.

Conclusions: The conclusions derived from this review are based on the best available scientific evidence in this field. It is intended that the results of this study will improve clinical decision-making and encourage the appropriate measures used to predict and prevent ulceration in people with diabetes at high risk of foot complications. Based on quality studies in this area, the results of this review have indicated that the use of temperature-monitoring is an effective way to predict, and thus prevent, diabetic foot ulceration.

No MeSH data available.


Related in: MedlinePlus