SynthesisDiabetologia2021
Prognostic models for predicting the risk of foot ulcer or amputation in people with type 2 diabetes: a systematic review and external validation study.
Synthesis in Diabetologia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Prognostic models for clinical outcomes in patients with venous leg ulcers: A systematic review.Journal of vascular surgery. Venous and lymphatic disorders · 2024Pooled it
- A narrative review of what cohorts have taught us and how they have laid the foundation for much of our understanding of type 2 diabetes.Diabetologia · 2026Review
- C-reactive protein-to-albumin ratio improves prediction of 6-month major adverse limb events in diabetic foot ulcers: a retrospective cohort study.Frontiers in endocrinology · 2026Article
- Article
- Evaluation of wound regeneration potential of nano-phytoextracts loaded carboxymethyl chitosan scaffolds for diabetic foot ulcer.Scientific reports · 2025Article
- The reporting quality and methodological quality of dynamic prediction models for cancer prognosis.BMC medical research methodology · 2025Article
- External validation of the DIAFORA system to predict lower-extremity amputations in a prospective Danish cohort.Diabetic medicine : a journal of the British Diabetic Association · 2025Article
- From Ulcer to Amputation: A Systematic Review of Prognostic Models for Diabetic Foot Ulcer Amputation.Risk management and healthcare policy · 2025Review
- Personalized and predictive strategies for diabetic foot ulcer prevention and therapeutic management: potential improvements through introducing Artificial Intelligence and wearable technology.Medicine and pharmacy reports · 2024Review
- A tool to predict the risk of lower extremity amputation in patients starting dialysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Article
- Comparative study on the efficacy of PRP gel and UC-MSCs gel as adjuvant therapies in the treatment of DFU wounds.Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI) · 2024Article
- Cardiovascular risk in diabetes mellitus: epidemiology, assessment and prevention.Nature reviews. Cardiology · 2023Review
- Risk prediction models for diabetic foot ulcer development or amputation: a review of reviews.Journal of foot and ankle research · 2023Review
- DNA methylation age acceleration is associated with risk of diabetes complications.Communications medicine · 2023Article
- Precision prognostics for the development of complications in diabetes.Diabetologia · 2022Review
- Pedal Vessel Calcification and Risk of Major Adverse Foot Events in the Diabetic Neuropathic, Nephropathic Foot.Journal of the American Podiatric Medical AssociationArticle
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims/hypothesisApproximately 25% of people with type 2 diabetes experience a foot ulcer and their risk of amputation is 10-20 times higher than that of people without type 2 diabetes. Prognostic models can aid in targeted monitoring but an overview of their performance is lacking. This study aimed to systematically review prognostic models for the risk of foot ulcer or amputation and quantify their predictive performance in an independent cohort.
methodsA systematic review identified studies developing prognostic models for foot ulcer or amputation over minimal 1 year follow-up applicable to people with type 2 diabetes. After data extraction and risk of bias assessment (both in duplicate), selected models were externally validated in a prospective cohort with a 5 year follow-up in terms of discrimination (C statistics) and calibration (calibration plots).
resultsWe identified 21 studies with 34 models predicting polyneuropathy, foot ulcer or amputation. Eleven models were validated in 7624 participants, of whom 485 developed an ulcer and 70 underwent amputation. The models for foot ulcer showed C statistics (95% CI) ranging from 0.54 (0.54, 0.54) to 0.81 (0.75, 0.86) and models for amputation showed C statistics (95% CI) ranging from 0.63 (0.55, 0.71) to 0.86 (0.78, 0.94). Most models underestimated the ulcer or amputation risk in the highest risk quintiles. Three models performed well to predict a combined endpoint of amputation and foot ulcer (C statistics >0.75). CONCLUSIONS/
interpretationThirty-four prognostic models for the risk of foot ulcer or amputation were identified. Although the performance of the models varied considerably, three models performed well to predict foot ulcer or amputation and may be applicable to clinical practice.
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