Professor Jeffcoate and colleagues have published a paper in the Lancet Diabetes & Endocrinology that is a must read for anyone who wants to execute or read scientific studies on diabetic foot ulcers. Their paper, on behalf of the International Working Group on the Diabetic Foot and the European Wound Management Association, describes the “Reporting standards of studies and papers on the prevention and management of foot ulcers in diabetes: required details and markers of god quality”. In short: what makes up a good study on diabetic foot ulcers?
We all want evidence-based practice, especially when interventions are applied. However, everyone who has read a systematic review knows the frustration of conclusions along the line of “more high-quality research is needed”. Such reviews are not very helpful in daily practice, as they still cannot tell what interventions are effective (or not).
An important reason why systematic reviews end with that conclusion is poor reporting in articles. More often than not, essential information is missing from the publication. For example, failure to describe ulcer risk of patients included in an ulcer prevention study leaves the reader guessing whether these are patients at very high risk (e.g. all with a recently ulcer) or at very low risk (e.g. newly developed diabetes and no neuropathy); or in a study on ulcer healing, a failure to classify peripheral artery disease and infection, although both will have major impact on healing outcomes.
Jeffcoate and colleagues have now written this seminal paper to hopefully overcome poor reporting in the future. Their article describes the minimally needed information, with detailed descriptions of why that information is needed. For anyone (thinking of) preparing a study on diabetic foot ulcers: this is a must-read and must-use article.
If you are not planning to undertake studies yourself, this article is also a great read for everyone who reads papers on diabetic foot ulcers. The authors provide a 21-item checklist you can use to assess the quality of a study. These items are based on quality items for general randomized controlled trials, with additions specifically applicable to diabetic foot ulcers. For journal clubs, if you’re reading an article for continuing professional development, or if you just want a quick check to get a grasp on the quality of a paper: use this list.
In conclusion, this is a paper that will be hopefully be used by researchers and clinicians all over the world, to improve the quality of future studies on diabetic foot ulcers. The article is available online here, and we again like to stress the need to read.