SynthesisThe British journal of dermatology2019
A systematic review showing the lack of diagnostic criteria and tools developed for lower-limb cellulitis.
Synthesis in The British journal of dermatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Diagnostic stewardship and dermatology consultation in cellulitis management: a systematic literature review and meta-analysis.Archives of dermatological research · 2024Pooled it
- Misdiagnosis of Uncomplicated Cellulitis: a Systematic Review and Meta-analysis.Journal of general internal medicine · 2023Pooled it
- Unmet needs in cellulitis diagnosis: a qualitative interview study to understand healthcare professionals' knowledge and experiences.BMJ open · 2026Article
- Development of a digital image analysis system for objective evaluation of treatment response in cellulitis.Scientific reports · 2025Article
- Reducing inappropriate investigations for minor lower limb cellulitis.BMJ open quality · 2025Article
- Review
- Review
- Article
- The impact of a point-of-care visual clinical decision support tool on admissions for cellulitis in the University of Maryland medical system.Journal of the American College of Emergency Physicians open · 2023Article
- Diagnosis and treatment of the invasive extension of bacteria (cellulitis) from chronic wounds utilising point-of-care fluorescence imaging.International wound journal · 2022Observational
- Cellulitis in chronic oedema.The British journal of dermatology · 2021Article
- An interview study to determine the experiences of cellulitis diagnosis amongst health care professionals in the UK.BMJ open · 2020Article
- Confidence of recurrent cellulitis self-diagnosis among people with lymphoedema: a qualitative interview study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCellulitis can be a difficult diagnosis to make. Furthermore, 31% of patients admitted from the emergency department with suspected lower-limb cellulitis have been misdiagnosed, with incorrect treatment potentially resulting in avoidable hospital admission and the prescription of unnecessary antibiotics.
objectivesWe sought to identify diagnostic criteria or tools that have been developed for lower-limb cellulitis.
methodsWe conducted a systematic review using Ovid MEDLINE and Embase databases in May 2018, with the aim of describing diagnostic criteria and tools developed for lower-limb cellulitis, and we assessed the quality of the studies identified using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. We included all types of study that described diagnostic criteria or tools.
resultsEight observational studies were included. Five studies examined biochemical markers, two studies assessed imaging and one study developed a diagnostic decision model. All eight studies were considered to have a high risk for bias in at least one domain. The quantity and quality of available data was low and results could not be pooled owing to the heterogeneity of the findings.
conclusionsThere is a lack of high-quality publications describing criteria or tools for diagnosing lower-limb cellulitis. Future studies using prospective designs, validated in both primary and secondary care settings, are needed. What's already known about this topic? Diagnosing lower-limb cellulitis on first presentation is challenging. Approximately one in three patients admitted from the emergency department with suspected lower-limb cellulitis do not have cellulitis and are given another diagnosis on discharge. Consequently, this results in potentially avoidable hospital admissions and the prescription of unnecessary antibiotics. There are no diagnostic criteria available for lower-limb cellulitis in the U.K. What does this study add? This systematic review has identified a key research gap in the diagnosis of lower-limb cellulitis. There is a current lack of robustly developed and validated diagnostic criteria or tools for use in clinical practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.