Table IV.
Four key clinical tasks addressed by multidisciplinary teams
| Study | Bias score (1) |
OR for major amputation |
Key clinical task | # tasks addressed |
|||||
|---|---|---|---|---|---|---|---|---|---|
| Glycemic control |
Wound care | Infection | Vascular Disease | ||||||
| Surgical | Non-surgical | Revascularization | Diagnostic/ Medically managed |
||||||
| Chung 2015 | 20 | 0.45 (0.16, 1.24) | X | X | X | X | X | X | 4 |
| Weck 2013 | 18.5 | 0.28 (0.20, 0.40) | X | X | X | X | X | 4 | |
| Laakso 2017 | 17.5 | 0.47 (0.27, 0.82) | X | X | X | X | X | X | 4 |
| Chiu 2011 | 17 | 0.09 (0.03, 0.29) | X | X | X | X | X | 3 | |
| Alexandrescu 2009 | 16.5 | 0.47 (0.20, 1.08) | X | X | X | X | X | X | 4 |
| Crihana 2014 | 16.5 | 0.25 (0.07, 0.90) | X | X | X | X | X | 4 | |
| Setacci 2013 | 16.5 | 0.70 (0.50, 0.96) | X | X | X | X | X | 3 | |
| Kim 2018 | 16.5 | 1.14 (0.59, 2.20) | X | X | X | X | X | 3 | |
| Riaz 2019 | 16.5 | 0.29 (0.20, 0.42) | X | X | X | X | X | 3 | |
| Dargis 1999 | 16 | 0.39 (0.04, 3.55) | X | X | X | X | 3 | ||
| Hedetoft 2009 | 16 | * | X | X | X | 2 | |||
| Martinez-Gómez 2014 | 16 | 0.47 (0.33, 0.68) | X | X | X | X | X | 4 | |
| Rerkasem 2008 | 16 | 0.27 (0.08, 0.97) | X | X | X | X | X | 3 | |
| Williams 2018 | 16 | −368/100,000 | X | X | X | X | 2 | ||
| Yesil 2009 | 16 | 0.56 (0.34, 0.93) | X | X | X | X | X | X | 4 |
| Cahn 2014 | 15.5 | 0.49 (0.25, 0.94) | X | X | X | X | 3 | ||
| Wang 2016 | 15.5 | 0.27 (0.13, 0.57) | X | X | X | X | X | 3 | |
| Jiménez 2017 | 15.5 | −1.6/100,000/yr | X | X | X | X | X | X | 4 |
| Crane 1999 | 15 | 0.30 (0.10, 0.92) | X | X | 2 | ||||
| Denjalic 2014 | 15 | 0.49 (0.30, 0.78) | X | X | X | X | 3 | ||
| Nather 2010 | 15 | 0.37 (0.21, 0.66) | X | X | X | X | X | X | 4 |
| Armstrong 2012 | 14.5 | ** | X | X | X | X | X | 3 | |
| Aydin 2010 | 14.5 | 0.53 (0.25, 1.15) | X | X | X | X | X | X | 4 |
| Hsu 2015 | 14.5 | 0.28 (0.13, 0.60) | X | X | X | X | X | 3 | |
| Meltzer 2002 | 14.5 | 0.16 (0.07, 0.37) | X | X | X | X | X | X | 4 |
| Witsø 2010 | 14.5 | −160/100,000/yr | X | X | X | X | X | X | 4 |
| Anichini 2007 | 14 | −3.2/100,000 | X | X | X | X | X | 3 | |
| Gibbons 1993 | 13.5 | 0.22 (0.10, 0.47) | X | X | X | 2 | |||
| Holstein 2000 | 13.5 | −20.3/100,000 | X | X | X | X | X | X | 4 |
| Nason 2013 | 13.5 | 0.61 (0.23, 1.62) | X | X | X | X | X | X | 4 |
| Troisi 2016 | 11.5 | −8.8/100,000 | X | X | 1 | ||||
| McGill 2003 | 9.5 | 0.19 (0.13, 0.27) | X | X | X | 2 | |||
| Total (%) | 27 (84) | 28 (88) | 29 (91) | 20 (63) | 24 (75) | 27 (84) | Mean= 3.22 | ||
(1)
Studies are ordered based on bias scores, with higher quality studies listed first.
*
Hedetoft and colleagues reported a reduction in the high:low (major:minor) amputation ratio from 0.56 to 0.46 following introduction of a multidisciplinary team.
**
Armstrong and colleagues reported a reduction in the high:low (major:minor) amputation ratio from 0.35 to 0.27 following introduction of a multidisciplinary team.