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Journal of Foot and Ankle Research
Published in: Journal of Foot and Ankle Research 1/2013

Open Access 01-12-2013 | Review

Developing an evidence-based clinical pathway for the assessment, diagnosis and management of acute Charcot Neuro-Arthropathy: a systematic review

Authors: Tamara E Milne, Joseph R Rogers, Ewan M Kinnear, Helen V Martin, Peter A Lazzarini, Thomas R Quinton, Frances M Boyle

Published in: Journal of Foot and Ankle Research | Issue 1/2013

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Abstract

Background

Charcot Neuro-Arthropathy (CN) is one of the more devastating complications of diabetes. To the best of the authors’ knowledge, it appears that no clinical tools based on a systematic review of existing literature have been developed to manage acute CN. Thus, the aim of this paper was to systematically review existing literature and develop an evidence-based clinical pathway for the assessment, diagnosis and management of acute CN in patients with diabetes.

Methods

Electronic databases (Medline, PubMed, CINAHL, Embase and Cochrane Library), reference lists, and relevant key websites were systematically searched for literature discussing the assessment, diagnosis and/or management of acute CN published between 2002-2012. At least two independent investigators then quality rated and graded the evidence of each included paper. Consistent recommendations emanating from the included papers were then fashioned in a clinical pathway.

Results

The systematic search identified 267 manuscripts, of which 117 (44%) met the inclusion criteria for this study. Most manuscripts discussing the assessment, diagnosis and/or management of acute CN constituted level IV (case series) or EO (expert opinion) evidence. The included literature was used to develop an evidence-based clinical pathway for the assessment, investigations, diagnosis and management of acute CN.

Conclusions

This research has assisted in developing a comprehensive, evidence-based clinical pathway to promote consistent and optimal practice in the assessment, diagnosis and management of acute CN. The pathway aims to support health professionals in making early diagnosis and providing appropriate immediate management of acute CN, ultimately reducing its associated complications such as amputations and hospitalisations.
Appendix
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Metadata
Title
Developing an evidence-based clinical pathway for the assessment, diagnosis and management of acute Charcot Neuro-Arthropathy: a systematic review
Authors
Tamara E Milne
Joseph R Rogers
Ewan M Kinnear
Helen V Martin
Peter A Lazzarini
Thomas R Quinton
Frances M Boyle
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Journal of Foot and Ankle Research / Issue 1/2013
Electronic ISSN: 1757-1146
DOI
https://doi.org/10.1186/1757-1146-6-30

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