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Complex interventions for preventing diabetic foot ulceration

Overview of attention for article published in Cochrane database of systematic reviews, August 2015
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (92nd percentile)
  • Good Attention Score compared to outputs of the same age and source (70th percentile)

Mentioned by

blogs
1 blog
twitter
21 tweeters
facebook
3 Facebook pages
googleplus
1 Google+ user

Citations

dimensions_citation
25 Dimensions

Readers on

mendeley
231 Mendeley
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Title
Complex interventions for preventing diabetic foot ulceration
Published in
Cochrane database of systematic reviews, August 2015
DOI 10.1002/14651858.cd007610.pub3
Pubmed ID
Authors

Ruben C Hoogeveen, Johannes AN Dorresteijn, Didi MW Kriegsman, Gerlof D Valk

Abstract

Ulceration of the feet, which can lead to the amputation of feet and legs, is a major problem for people with diabetes mellitus, and can cause substantial economic burden. Single preventive strategies have not been shown to reduce the incidence of foot ulceration to a significant extent. Therefore, in clinical practice, preventive interventions directed at patients, healthcare providers and/or the structure of health care are often combined (complex interventions). To assess the effectiveness of complex interventions in the prevention of foot ulcers in people with diabetes mellitus compared with single interventions, usual care or alternative complex interventions. A complex intervention is defined as an integrated care approach, combining two or more prevention strategies on at least two different levels of care: the patient, the healthcare provider and/or the structure of health care. For the second update we searched the Cochrane Wounds Group Specialised Register (searched 22 May 2015), The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2015, Issue 4), The Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library 2015, Issue 4), The Health Technology Assessment Database (HTA) (The Cochrane Library 2015, Issue 4), The NHS Economic Evaluation Database (NHS EED) (The Cochrane Library 2015, Issue 4), Ovid MEDLINE (1946 to 22 May 2015), Ovid MEDLINE (In-Process & Other Non-Indexed Citations 21 May, 2015), Ovid EMBASE (1974 to 21 May, 2015) and EBSCO CINAHL (1982 to 22 May, 2015). Prospective randomised controlled trials (RCTs) which compared the effectiveness of combinations of preventive strategies, not solely patient education, for the prevention of foot ulcers in people with diabetes mellitus, with single interventions, usual care or alternative complex interventions. Two review authors were assigned to independently select studies, to extract study data and to assess risk of bias of included studies, using predefined criteria. Only six RCTs met the criteria for inclusion. The study characteristics differed substantially in terms of healthcare settings, the nature of the interventions studied and outcome measures reported. In three studies that compared the effect of an education-centred complex intervention with usual care or written instructions, only little evidence of benefit was found. Three studies compared the effect of more intensive and comprehensive complex interventions with usual care. One study found a significant and cost-effective reduction, one of lower extremity amputations (RR 0.30, 95% CI 0.31 to 0.71). One other study found a significant reduction of both amputation and foot ulcers. The last study reported improvement of patients' self care behaviour. All six included RCTs were at high risk of bias, with hardly any of the predefined quality assessment criteria met. There is no high-quality research evidence evaluating complex interventions for preventing diabetic foot ulceration and insufficient evidence of benefit.

Twitter Demographics

The data shown below were collected from the profiles of 21 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 231 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Spain 1 <1%
Canada 1 <1%
Unknown 228 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 47 20%
Student > Bachelor 35 15%
Researcher 32 14%
Student > Ph. D. Student 17 7%
Student > Postgraduate 16 7%
Other 55 24%
Unknown 29 13%
Readers by discipline Count As %
Medicine and Dentistry 88 38%
Nursing and Health Professions 53 23%
Psychology 9 4%
Social Sciences 9 4%
Agricultural and Biological Sciences 6 3%
Other 26 11%
Unknown 40 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 21. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 May 2018.
All research outputs
#833,166
of 14,251,174 outputs
Outputs from Cochrane database of systematic reviews
#2,541
of 10,917 outputs
Outputs of similar age
#18,384
of 239,528 outputs
Outputs of similar age from Cochrane database of systematic reviews
#80
of 268 outputs
Altmetric has tracked 14,251,174 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 10,917 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.7. This one has done well, scoring higher than 76% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 239,528 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 268 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.