Flora Mbela Lusendi1,2* , An‑Sofie Vanherwegen1 , Kris Doggen1 , Frank Nobels3 and Giovanni Arnoldo Matricali2,4 *Correspondence: Flora Mbela Lusendi 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

1 Health Services Research, Sciensano, Rue Juliette Wytsmanstraat 14, Brussels 1050, Belgium

2 Department of Development and Regeneration, KU Leuven, Leuven, Belgium

3 Multidisciplinary Diabetic Foot Clinic, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium

4 Multidisciplinary Diabetic Foot Clinic, University Hospital Leuven, Leuven, Belgium

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Abstract

Background Foot ulcers in people with diabetes are a serious complication requiring a complex management and have a high societal impact. Quality monitoring systems to optimize diabetic foot care exist, but a formal and more evidence-based approach to develop quality indicators (QIs) is lacking. We aimed to identify a set of candi‑ date indicators for diabetic foot care by adopting an evidence-based methodology.

Methods A systematic search was conducted across four academic databases: PubMed, Embase CINAHL and Cochrane Library. Studies that reported evidence-based interventions related to organization or delivery of dia‑ betic foot care were searched. Data from the eligible studies were summarized and used to formulate process and structure indicators. The evidence for each candidate QI was described in a methodical and transparent manner. The review process was reported according to the “Preferred Reported Items for Systematic reviews and Meta-Analy‑ sis” (PRISMA) statements and its extension for scoping reviews.

Results In total, 981 full-text articles were screened, and 322 clinical studies were used to formulate 42 candidate QIs.

Conclusions An evidence-based approach could be used to select candidate indicators for diabetic foot ulcer care, relating to the following domains: wound healing interventions, peripheral artery disease, offloading, secondary pre‑ vention, and interventions related to organization of care. In a further step, the feasibility of the identified set of indica‑ tors will be assessed by a multidisciplinary panel of diabetic foot care stakeholders.

Keywords Diabetic foot ulcer, Quality of healthcare, Quality indicators, Evidence-based medicine, Health service research