SynthesisPloS one2022
The efficacy of inflammatory markers in diagnosing infected diabetic foot ulcers and diabetic foot osteomyelitis: Systematic review and meta-analysis.
Synthesis in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 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
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Is procalcitonin superior to CRP and ESR in the diagnosis of diabetic foot osteomyelitis? A systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- Diagnostic value and integrated threshold of ESR for diabetic foot osteomyelitis: a systemic review and meta-analysis.Frontiers in endocrinology · 2025Pooled it
- Causes of Bacterial Infections and Antibiotic Resistance Profiles in Patients with Chronic Wounds.Microorganisms · 2026Article
- Comparing the Diagnostic Accuracy of the Probe-to-Bone Test, Plain Radiography, and Serum Biomarkers in Detecting Diabetic Foot Osteomyelitis.Journal of clinical medicine · 2026Article
- Pilot randomised controlled trial of probe to bone diabetic foot ulcer therapy (PROBE-DFU trial) - Study protocol.PloS one · 2026Article
- Microbial dysbiosis and wound healing in diabetic foot ulcers: a mini review with a note on the role of artificial intelligence.Frontiers in cellular and infection microbiology · 2026Review
- Quantitative Bone SPECT/CT in Diabetic Foot Osteomyelitis: Diagnostic Performance Within-Patient Lesion-Contralateral Separation and Associations with Inflammatory Burden.Diagnostics (Basel, Switzerland) · 2025Article
- Role of C-reactive Protein (CRP) Levels and Glycemic Control in Outcome of Diabetic Foot Ulcer Healing.Cureus · 2025Article
- Prognostic value of the site, depth, and infection/ischemia classification system in diabetic foot ulcers: a retrospective cohort study.Scientific reports · 2025Article
- Development and external validation of machine-learning based models to predict diabetic foot ulcer in diabetes population.Frontiers in endocrinology · 2025Article
- Revisiting diagnostics: erythrocyte sedimentation rate and C-reactive protein: it is time to stop the zombie tests.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2025Article
- High-sensitivity C-reactive protein and all-cause mortality in patients with diabetic foot and osteoporosis: evidence from a retrospective cohort study.Frontiers in medicine · 2025Article
- Identification of Neutrophil Extracellular Trap-Related Biomarkers in Diabetic Foot Ulcers Based on Bioinformatics.Journal of inflammation research · 2025Article
- Harnessing the host response for precision infectious disease diagnosis.Clinical microbiology reviews · 2024Review
- Revisiting Antibiotic-Impregnated Cement Spacer for Diabetic Osteomyelitis of the Foot.Antibiotics (Basel, Switzerland) · 2024Article
- Analysis of clinical characteristics in patients with diabetic foot ulcers undergoing amputation and establishment of a nomogram prediction model.Scientific reports · 2024Article
- Overview of anti-inflammatory diets and their promising effects on non-communicable diseases.The British journal of nutrition · 2024Review
- Variation in Systemic Antibiotic Treatment for Diabetic Foot Osteomyelitis in England and Wales: A Multi-Centre Case Review.Journal of clinical medicine · 2024Article
- Diagnostic Performance of Atherogenic Index of Plasma for Predicting Diabetic Foot Osteomyelitis with Peripheral Artery Disease.Journal of clinical medicine · 2024Article
- Investigation and management of diabetic foot osteomyelitis: An update for the foot and ankle orthopaedic surgeon.Journal of clinical orthopaedics and trauma · 2024Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiabetes foot ulcer (DFU) is a complication of diabetes mellitus. Accurate diagnosis of DFU severity through inflammatory markers will assist in reducing impact on quality of life. We aimed to ascertain the diagnostic test accuracy of commonly used inflammatory markers such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), and white cell count (WCC) for the diagnosis and differentiation between DFU grades based on the International Working Group on the Diabetic Foot classification system.
methodsThis systematic review explored studies that investigated one or more of the above-listed index tests aiding in diagnosing infected DFU. This review was registered on PROSPERO database (ID = CRD42021255618) and searched 5 databases including an assessment of the references of included studies. Records were manually screened as per Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A total of 16 studies were included which were assessed for quality using QUADAS-2 tool and meta-analysed using Meta-Disc v1.4.
resultsCRP had the greatest area under the curve (AUC) of 0.893 for diagnosing grade 2 DFU. This returned a pooled sensitivity and specificity of 77.4% (95% CI: 72% to 82%) and 84.3% (95% CI: 79% to 89%) respectively. In terms of diagnosing grade 3 DFU, procalcitonin had the highest AUC value of 0.844 when compared with other markers. The pooled sensitivity of PCT was calculated as 85.5% (95% CI: 79% to 90%) and specificity as 68.9% (95% CI: 63% to 75%).
conclusionCRP and PCT are the best markers for diagnosing grade 2 and grade 3 DFU respectively. Other markers are also valuable when used in conjunction with clinical judgement. The findings accentuate the necessity of further research to establish standardised cut-off values for these inflammatory markers in diagnosing diabetic foot ulcers.
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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.