Elsevier, Diabetes Research and Clinical Practice, Volume 161, March 2020
Aims: To determine the pooled effectiveness of multidiscipinary care teams (MCTs) in reducing major amputation rates in adults with diabetes. Methods: A systematic review and meta-analysis was performed, searching databases MEDLINE, EMBASE, Google Scholar, Cochrane Library, and Clinicaltrials.gov thru October 2018. We included only before-after studies comparing amputation rates before and after the implementation of a MCT for the prevention of major amputation in adults with diabetes. Our primary outcome was relative risk of major amputation. Risk ratios and 95% confidence intervals were calculated using a fixed effects model. Results: Twenty studies met the inclusion criteria. Nine studies were included in the meta-analysis, and eleven were included in a qualitative analysis. Exposure to a MCT resulted in a protective effect ranging from a RR of 0.44 [p-value
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Keywords:
Above Knee Amputation; Adult; Amputation; Clinical Outcome; Diabetes Complications; Diabetes Mellitus; Diabetic Complication; Health Care Planning; Human; Humans; Interdisciplinary Communication; Meta Analysis; Odds Ratio; Organization And Management; Outcome Assessment; Patient Care; Patient Care Team; Predictive Value; Prevention Study; Qualitative Analysis; Review; Risk Factor; Surgical Risk; Systematic Review; Treatment Outcome; Global
