scholarly journals Australian guideline on wound classification of diabetes-related foot ulcers: part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Emma J. Hamilton ◽  
Joanna Scheepers ◽  
Hayley Ryan ◽  
Byron M. Perrin ◽  
James Charles ◽  
...  
Keyword(s):  
Health Professionals ◽  
Foot Ulcer ◽  
Classification Systems ◽  
Standards Of Care ◽  
Foot Ulcers ◽  
Future Research ◽  
Evidence Based ◽  
Australian Context ◽  
Wound Classification

Abstract Background Wound classification systems are useful tools to characterise diabetes-related foot ulcers (DFU) and are utilised for the purpose of clinical assessment, to promote effective communication between health professionals, and to support clinical audit and benchmarking. Australian guidelines regarding wound classification in patients with DFU are outdated. We aimed to adapt existing international guidelines for wound classification to develop new evidence-based Australian guidelines for wound classification in people with diabetes and DFU. Methods Recommended NHRMC procedures were followed to adapt suitable International Working Group on the Diabetic Foot (IWGDF) guidelines on wound classification to the Australian health context. Five IWGDF wound classification recommendations were evaluated and assessed according to the ADAPTE and GRADE systems. We compared our judgements with IWGDF judgements to decide if recommendations should be adopted, adapted or excluded in an Australian context. We re-evaluated the quality of evidence and strength of recommendation ratings, provided justifications for the recommendation and outlined any special considerations for implementation, subgroups, monitoring and future research in an Australian setting. Results After the five recommendations from the IWGDF 2019 guidelines on the classification of DFUs were evaluated by the panel, two were adopted and three were adapted to be more suitable for Australia. The main reasons for adapting, were to align the recommendations to existing Australian standards of care, especially in specialist settings, to maintain consistency with existing recommendations for documentation, audit and benchmarking and to be more appropriate, acceptable and applicable to an Australian context. In Australia, we recommend the use of the SINBAD system as a minimum standard to document the characteristics of a DFU for the purposes of communication among health professionals and for regional/national/international audit. In contrast to the IWGDF who recommend against usage, in Australia we recommend caution in the use of existing wound classification systems to provide an individual prognosis for a person with diabetes and a foot ulcer. Conclusions We have developed new guidelines for wound classification for people with diabetes and a foot ulcer that are appropriate and applicable for use across diverse care settings and geographical locations in Australia.

scholarly journals Repeatability, Completion Time, and Predictive Ability of Four Diabetes-Related Foot Ulcer Classification Systems

2021 ◽  
pp. 193229682098654
Author(s):  
Chanika Alahakoon ◽  
Malindu Fernando ◽  
Charith Galappaththy ◽  
Peter Lazzarini ◽  
Joseph V. Moxon ◽  
...  
Keyword(s):  
Foot Ulcer ◽  
Predictive Ability ◽  
Classification Systems ◽  
The Other ◽  
Observer Agreement ◽  
Foot Ulcers ◽  
Substantial Agreement ◽  
University Of Texas ◽  
Trained Observers ◽  
Completion Times

Introduction: The inter and intra-observer reproducibility of measuring the Wound Ischemia foot Infection (WIfI) score is unknown. The aims of this study were to compare the reproducibility, completion times and ability to predict 30-day amputation of the WIfI, University of Texas Wound Classification System (UTWCS), Site, Ischemia, Neuropathy, Bacterial Infection and Depth (SINBAD) and Wagner classifications systems using photographs of diabetes-related foot ulcers. Methods: Three trained observers independently scored the diabetes-related foot ulcers of 45 participants on two separate occasions using photographs. The inter- and intra-observer reproducibility were calculated using Krippendorff’s α. The completion times were compared with Kruskal-Wallis and Dunn’s post-hoc tests. The ability of the scores to predict 30-day amputation rates were assessed using receiver operator characteristic curves and area under the curves. Results: There was excellent intra-observer agreement (α >0.900) and substantial agreement between observers (α=0.788) in WIfI scoring. There was moderate, substantial, or excellent agreement within the three observers (α>0.599 in all instances except one) and fair or moderate agreement between observers (α of UTWCS=0.306, α of SINBAD=0.516, α of Wagner=0.374) for the other three classification systems. The WIfI score took significantly longer ( P<.001) to complete compared to the other three scores (medians and inter quartile ranges of the WIfI, UTWCS, SINBAD, and Wagner being 1.00 [0.88-1.00], 0.75 [0.50-0.75], 0.50 [0.50-0.50], and 0.25 [0.25-0.50] minutes). None of the classifications were predictive of 30-day amputation ( P>.05 in all instances). Conclusion: The WIfI score can be completed with substantial agreement between trained observers but was not predictive of 30-day amputation.

Health professionals' perspectives on delivering patient-focused wound management: a qualitative study

2019 ◽  
Vol 28 (Sup7) ◽  
pp. S4-S13 ◽  
Author(s):  
Janet L. Kuhnke ◽  
David Keast ◽  
Sue Rosenthal ◽  
Robyn Jones Evans
Keyword(s):  
Health Care ◽  
Health Professionals ◽  
Best Practice ◽  
Care Delivery ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Management ◽  
Evidence Based ◽  
Venous Leg Ulcer

Objective: This study examined the perspectives of health professionals on the barriers and solutions to delivery of patient-focused wound management and outcomes. Methods: A qualitative, descriptive study design was used. Participants were health-care managers, clinical leaders, nurses and allied health members who are part of wound care services. Open-ended surveys were distributed to participants in a series of learning workshops, and data analysed to identify leading themes. Results: A total of 261 participants took part and 194 surveys were returned (response rate: 74%). From the analysis five themes emerged: patient/family wound-related education; health professional wound-related education; implementation of evidence-based wound care and dissemination of evidence-based wound information across professions and contexts; teamwork and respectful communication within teams; and a higher value and priority placed on wound care through collaborative teams by managers, leaders and policymakers. Conclusion: Findings suggest that ongoing, system-wide education is needed to improve prevention, assessment, treatment and management of four wound types: venous leg ulcer (VLU), diabetic foot ulcer (DFU), pressure ulcer (PU) and surgical wounds. Health professionals are committed to delivering best practice in wound care. Participants identified that effective patient-focused, evidence-based wound care involves having a health-care system with a clear mandate to ensure wound care is a priority. A high value placed on wound care by managers and clinical leadership could transform the present systems. Additionally, effective and widespread dissemination of evidenced-informed practice information is crucial to positive patient outcomes. Education and team commitment for consistent and respectful communication would improve care delivery.

Basic Principles and Benefits of Various Classification Systems in Health

2011 ◽  
pp. 51-58
Author(s):  
Dimitra Petroudi ◽  
Athanasios Zekios
Keyword(s):  
Information Systems ◽  
Health Professionals ◽  
International Classification Of Diseases ◽  
Classification Systems ◽  
Coding System ◽  
Basic Principles ◽  
Medical Coding ◽  
Coding Systems ◽  
Classification Of Diseases

The introduction of information systems in health progressively led tï coding systems. The purposes of these systems are: recording causes of death, coding diseases and procedures, etc. The most important medical coding system in our days is ICD (International Classification of Diseases). Other coding systems that health professionals use are: SNOMED, LOINC, MeSH, UMLS, DSM, DRG and HCPCS. There are also many Nursing Classification Systems, such as: NANDA, NIC, NOC, ICNP, Omaha and HHCC. This chapter describes these coding systems and their advantages.

Physiotherapists and Evidence Based Practice: An Opportunity or Threat to the Profession?

2001 ◽  
Vol 6 (1) ◽  
pp. 62-74 ◽  
Author(s):  
Rose Wiles ◽  
Sue Barnard
Keyword(s):  
Health Professionals ◽  
Evidence Based Practice ◽  
Central Element ◽  
Professional Autonomy ◽  
Future Research ◽  
Evidence Based ◽  
The Status ◽  
Using Data ◽  
The Uk ◽  
The Impact

The profession of physiotherapy in the UK is undergoing a period of change. Prominent among these aspects of change is the movement to evidence based practice (EBP). EBP is a central element of policy in the National Health Service (NHS). It is being implemented in physiotherapy as a means of securing contracts with purchasers but also as a means of contesting challenges from alternative practitioners and health professionals to the areas of work that physiotherapists view as their territory. Using data collected from a qualitative study of 56 physiotherapists of different grades working in different sectors of the NHS, this paper explores physiotherapists’ views of EBP and the impact that they expect it to have on professional boundaries and on the status and practice of physiotherapy. The study indicated that physiotherapists’ views may differ according to their position in the profession. Senior physiotherapists appeared to view the development of EBP as a threat to the profession which would decrease professional autonomy and the status of the profession. In contrast, junior and superintendent physiotherapists appeared to view EBP as an opportunity for strengthening the profession. The impact EBP will have on the profession of physiotherapy and its relationships with a range of health professionals is as yet unknown as are the responses that physiotherapists are likely to have to this development. This study identifies the areas in which conflicts are likely to be played out. A focus for future research analysing the impact of EBP is suggested.

scholarly journals Physiotherapy for epidermolysis bullosa: clinical practice guidelines

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Amy Weisman ◽  
Jennifer M. Chan ◽  
Chantal LaPointe ◽  
Kaye Sjoholm ◽  
Kristy Steinau ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Epidermolysis Bullosa ◽  
Functional Mobility ◽  
Standards Of Care ◽  
Future Research ◽  
Evidence Based ◽  
Minor Trauma ◽  
Clinical Expertise ◽  
Clinical Practices ◽  
Physiotherapy Practice

AbstractEpidermolysis bullosa (EB) is characterized by skin fragility with blister formation occurring spontaneously or following minor trauma such as gentle pressure or friction. Current physiotherapy practice is based on anecdotal care, clinical expertise and creative problem solving with caregivers and individuals with EB. Evidence based intervention is needed to establish a foundation of knowledge and to guide international practitioners to create and improve standards of care to effectively work with individuals living with EB. This clinical practice guideline (CPG) was created for the purpose of providing evidence based interventions and best clinical practices for the physiotherapy management of individuals with EB. A survey was conducted within the EB community and six outcomes were identified as a priority to address in physiotherapy management, including (1) attaining developmental motor milestones, (2) identifying safe and functional mobility in the natural environment, (3) encouraging ambulation endurance, (4) supporting safe ability to bear weight, (5) improving access to physiotherapy services, and (6) optimizing interaction with the community. A systematic literature review was conducted and articles were critically analyzed by an international panel consisting of thirteen members: healthcare professionals (including physiotherapist, doctors, and occupational therapist), caregivers, and individuals with EB. Recommendations were formulated from evidence and panel consensus. An external panel of twelve were invited to improve the quality and gather feedback on draft manuscript and recommendations. This CPG describes the development of recommendations for physiotherapy management including several best practice interventions. This guideline lays the foundational work for physiotherapist throughout the world to provide high quality services while improving and maintaining functional mobility and independence within the EB community. The CPG outlines limitations in the evidence available and possible future research needed to improve physiotherapy practice.

The Importance of Evidence Based Practices and Autism

2020 ◽  
Author(s):  
Jessica Paynter ◽  
Marleen Westerveld ◽  
Rhylee Sulek
Keyword(s):  
Opportunity Cost ◽  
Information Access ◽  
Empirical Support ◽  
Autism Spectrum ◽  
Classification Systems ◽  
Individual Factors ◽  
Evidence Based ◽  
Allied Health Professionals ◽  
Evidence Based Practices

Autism Spectrum Disorder attracts a range of practices, interventions, and treatments ranging from those with empirical support of positively influencing outcomes, through to those with implausible theoretical bases, evidence of ineffectiveness, or indeed harm. In this chapter, we overview, why evidence based practices (EBPs) are important in the field of autism. This includes defining evidence based practice including both the broader framework and the specific classification of practices as EBPs, and summarising recent reviews that have classified practices as EBPs. We highlight that EBPs are important in the context of the ongoing use of unsupported practices by parents, in early intervention, by teachers, and by allied health professionals. We discuss the harms associated with non-use of EBPs and use of unsupported practices including direct harm, false hope, and financial and opportunity cost. We argue that using EBPs is the ethical approach which supports human rights, but acknowledge challenges in translation to practice including terminology and classification, systems factors, and individual factors including information access and attitudes.

Cognitive Predictors of Performance in Well-Trained Table Tennis Players With Intellectual Disability

2016 ◽  
Vol 33 (4) ◽  
pp. 324-337 ◽  
Author(s):  
Debbie Van Biesen ◽  
Jennifer Mactavish ◽  
Janne Kerremans ◽  
Yves C. Vanlandewijck
Keyword(s):  
Intellectual Disability ◽  
Reaction Time ◽  
Visual Processing ◽  
Spatial Visualization ◽  
Classification Systems ◽  
Cognitive Test ◽  
Future Research ◽  
Evidence Based ◽  
Table Tennis ◽  
Tennis Players

Evidence-based classification systems in Paralympic sport require knowledge of the underlying effect of impairment in a specific sport. This study investigated the relationship between cognition and tactical proficiency in 88 well-trained table tennis players with intellectual disability (ID; 29 women, 59 men, M ± SD IQ 59.9 ± 9.6). Data were collected at 3 competitions sanctioned by the International Federation for Para-Athletes with Intellectual Disabilities (INAS). A generic cognitive test consisting of 8 neuropsychological subtests was used to assess cognitive abilities relevant to sport (reaction time, processing speed, and decision speed; spatial visualization; fluid reasoning; memory; executive functioning; and visual processing). The backward stepwise-regression analysis model revealed that 18% of the variance in tactical proficiency was attributed to spatial visualization and simple reaction time. Applications of these findings resulted in an evidence-based classification system that led to the reinclusion of athletes with ID in Paralympic table tennis and provide the basis for future research in this important area.

scholarly journals A Comparison of Two Diabetic Foot Ulcer Classification Systems: The Wagner and the University of Texas wound classification systems

Diabetes Care ◽  
2001 ◽  
Vol 24 (1) ◽  
pp. 84-88 ◽  
Author(s):  
S. O. Oyibo ◽  
E. B. Jude ◽  
I. Tarawneh ◽  
H. C. Nguyen ◽  
L. B. Harkless ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Classification Systems ◽  
University Of Texas ◽  
Wound Classification ◽  
The University

scholarly journals PEDIS Classification in Diabetic Foot Ulcers Patients

2020 ◽  
Vol 1 (2) ◽  
pp. 50-54
Author(s):  
Radi Noorsyawal ◽  
Fahmi Jaka Yusuf ◽  
Kemas Dahlan ◽  
Ratna Maila Dewi
Keyword(s):  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
The United States ◽  
Classification Systems ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Peripheral Arterial

Introduction: Diabetic foot ulcer are one of several serious complications of diabetes progression. Up to 15% of patients with diabetes have diabetic foot ulcer and these ulcers lead to more than 80,000 amputations per year in the United States. Many DFU classification systems have been proposed to predict clinical outcome; however, almost of these systems have limitations. To categorize and define DFU objectively, the International Working Group of the Diabetic Foot (IWGDF) developed the PEDIS classification system. These collective findings and because of there is no findings of characteristic of DFU based on PEDIS classification in Mohammad Hoesin Hospital indicate that this research is needed to do. Method: This is a prospective study at Mohammad Hoesin hospital, Palembang. The aim is to describe the characteristic of diabetic foot ulcers based on PEDIS classification. There were 41 cases evaluated under this study. Results: Peripheral arterial disease is the most problem in perfusion. 1-3 cm2 is the most happen in extent. Wound depth on fascia or muscle or tendon is the most happen. Abscess or fascitis is the most problem in infection. Loss of sensation is the most happen. PEDIS score ≥ 7 is the most happen. Conclusion: Early prevention and treatment from vascular and endovascular surgery can be considered as the most important for the management of diabetic foot ulcers patient. Keywords: Diabetic Foot Ulcer, PEDIS classification, Peripheral Arterial Disease

scholarly journals How has the family firm literature addressed its heterogeneity through classification systems? An integrated analysis

2017 ◽  
Vol 7 (1-2) ◽  
Author(s):  
Remedios Hernández-Linares ◽  
Soumodip Sarkar ◽  
Mª Concepción López-Fernández
Keyword(s):  
Family Business ◽  
Family Firms ◽  
Classification Systems ◽  
Future Research ◽  
Integrated Analysis ◽  
Comprehensive Review ◽  
Classification Schemes ◽  
The Core ◽  
The Family

Extant literature recognizes both family business heterogeneity and the need to identify relevant definitional criteria to distinguish family firms, leading to the emergence of typologies, taxonomies and classification schemes. This paper presents a comprehensive review of existing classifications, which we the compare with the core conceptual elements embedded in 258 family business definitions. Our analyses enables an identification of the characteristics of the entities being classified, and then we proceed to reflect on their usefulness and effectiveness for classifying family firms. Based on the integrated analysis, we then propose some recommendations and future research lines in order to develop a workable classification of family firms.

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