TY - JOUR
T1 - Guidelines development protocol and findings
T2 - Part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease
AU - Lazzarini, Peter A.
AU - Raspovic, Anita
AU - Prentice, Jenny
AU - Commons, Robert J.
AU - Fitridge, Robert A.
AU - Charles, James
AU - Cheney, Jane
AU - Purcell, Nytasha
AU - Twigg, Stephen M.
AU - on behalf of the Australian Diabetes-related Foot Disease Guidelines & Pathways Project
N1 - Funding Information:
The Australian Diabetes-related Foot Disease Guidelines & Pathways Project received partial funding from the National Diabetes Services Scheme and in-kind secretariat support and oversight from Diabetes Feet Australia and the Australian Diabetes Society.
Funding Information:
We wish to acknowledge the kind assistance and permission of the 2019 IWGDF Guideline Editorial Board for providing permission for us to adapt the 2019 IWGDF guidelines for the purpose of these new Australian guidelines: Professor Nicolaas Schaper (Chair), A/Professor Jaap van Netten (Secretary), Professor Jan Apelqvist, Professor Robert Hinchliffe, Professor Benjamin Lipsky, and A/Professor Sicco Bus, on behalf of all 2019 IWGDF Guideline Chapter Groups. Furthermore, we very warmly acknowledge the national expert panel members that so kindly volunteered their valuable times to screen, assess, decide on and draft the new Australian guideline manuscripts that accompany this manuscript. The list of names of all panel members can be found in Table of this manuscript. Finally, PAL acknowledges support by an Australian NHMRC Early Career Fellowship (1143435) and RJC by an Australian NHMRC Emerging Leader Investigator Grant (1194702).
Funding Information:
We wish to acknowledge the kind assistance and permission of the 2019 IWGDF Guideline Editorial Board for providing permission for us to adapt the 2019 IWGDF guidelines for the purpose of these new Australian guidelines: Professor Nicolaas Schaper (Chair), A/Professor Jaap van Netten (Secretary), Professor Jan Apelqvist, Professor Robert Hinchliffe, Professor Benjamin Lipsky, and A/Professor Sicco Bus, on behalf of all 2019 IWGDF Guideline Chapter Groups. Furthermore, we very warmly acknowledge the national expert panel members that so kindly volunteered their valuable times to screen, assess, decide on and draft the new Australian guideline manuscripts that accompany this manuscript. The list of names of all panel members can be found in Table 3 of this manuscript. Finally, PAL acknowledges support by an Australian NHMRC Early Career Fellowship (1143435) and RJC by an Australian NHMRC Emerging Leader Investigator Grant (1194702).
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/4
Y1 - 2022/4
N2 - Background: Diabetes-related foot disease (DFD) is a leading cause of the Australian disease burden. The 2011 Australian DFD guidelines were outdated. We aimed to develop methodology for systematically adapting suitable international guidelines to the Australian context to become the new Australian evidence-based guidelines for DFD. Methods: We followed the Australian National Health Medical Research Council (NHMRC) guidelines for adapting guidelines. We systematically searched for all international DFD guideline records. All identified records were independently screened and assessed for eligibility. Those deemed eligible were further assessed and included if scoring at least moderate quality, suitability and currency using AGREE II and NHMRC instruments. The included international guidelines had all recommendations extracted into six sub-fields: prevention, wound classification, peripheral artery disease, infection, offloading and wound healing. Six national panels, each comprising 6–8 multidisciplinary national experts, screened all recommendations within their sub-field for acceptability and applicability in Australia using an ADAPTE form. Where panels were unsure of any acceptability and applicability items, full assessments were undertaken using a GRADE Evidence to Decision tool. Recommendations were adopted, adapted, or excluded, based on the agreement between the panel’s and international guideline’s judgements. Each panel drafted a guideline that included all their recommendations, rationale, justifications, and implementation considerations. All underwent public consultation, final revision, and approval by national peak bodies. Results: We screened 182 identified records, assessed 24 full text records, and after further quality, suitability, and currency assessment, one record was deemed a suitable international guideline, the International Working Group Diabetic Foot Guidelines (IWGDF guidelines). The six panels collectively assessed 100 IWGDF recommendations, with 71 being adopted, 27 adapted, and two excluded for the Australian context. We received 47 public consultation responses with > 80% (strongly) agreeing that the guidelines should be approved, and ten national peak bodies endorsed the final six guidelines. The six guidelines and this protocol can be found at: https://www.diabetesfeetaustralia.org/new-guidelines/Conclusion: New Australian evidence-based guidelines for DFD have been developed for the first time in a decade by adapting suitable international guidelines. The methodology developed for adaptation may be useful for other foot-related conditions. These new guidelines will now serve as the national multidisciplinary best practice standards of DFD care in Australia.
AB - Background: Diabetes-related foot disease (DFD) is a leading cause of the Australian disease burden. The 2011 Australian DFD guidelines were outdated. We aimed to develop methodology for systematically adapting suitable international guidelines to the Australian context to become the new Australian evidence-based guidelines for DFD. Methods: We followed the Australian National Health Medical Research Council (NHMRC) guidelines for adapting guidelines. We systematically searched for all international DFD guideline records. All identified records were independently screened and assessed for eligibility. Those deemed eligible were further assessed and included if scoring at least moderate quality, suitability and currency using AGREE II and NHMRC instruments. The included international guidelines had all recommendations extracted into six sub-fields: prevention, wound classification, peripheral artery disease, infection, offloading and wound healing. Six national panels, each comprising 6–8 multidisciplinary national experts, screened all recommendations within their sub-field for acceptability and applicability in Australia using an ADAPTE form. Where panels were unsure of any acceptability and applicability items, full assessments were undertaken using a GRADE Evidence to Decision tool. Recommendations were adopted, adapted, or excluded, based on the agreement between the panel’s and international guideline’s judgements. Each panel drafted a guideline that included all their recommendations, rationale, justifications, and implementation considerations. All underwent public consultation, final revision, and approval by national peak bodies. Results: We screened 182 identified records, assessed 24 full text records, and after further quality, suitability, and currency assessment, one record was deemed a suitable international guideline, the International Working Group Diabetic Foot Guidelines (IWGDF guidelines). The six panels collectively assessed 100 IWGDF recommendations, with 71 being adopted, 27 adapted, and two excluded for the Australian context. We received 47 public consultation responses with > 80% (strongly) agreeing that the guidelines should be approved, and ten national peak bodies endorsed the final six guidelines. The six guidelines and this protocol can be found at: https://www.diabetesfeetaustralia.org/new-guidelines/Conclusion: New Australian evidence-based guidelines for DFD have been developed for the first time in a decade by adapting suitable international guidelines. The methodology developed for adaptation may be useful for other foot-related conditions. These new guidelines will now serve as the national multidisciplinary best practice standards of DFD care in Australia.
KW - Classification
KW - Diabetes-related foot disease
KW - Diabetic foot
KW - Guidelines
KW - Infection
KW - Offloading
KW - Peripheral artery disease
KW - Peripheral neuropathy
KW - Ulcers
KW - Wounds
UR - http://www.scopus.com/inward/record.url?scp=85128735549&partnerID=8YFLogxK
U2 - 10.1186/s13047-022-00533-8
DO - 10.1186/s13047-022-00533-8
M3 - Article
C2 - 35440052
AN - SCOPUS:85128735549
VL - 15
SP - 1
EP - 17
JO - Journal of Foot and Ankle Research
JF - Journal of Foot and Ankle Research
SN - 1757-1146
IS - 1
M1 - 28
ER -