Clinical decision support systems for diabetic foot ulcers: a scoping review.
Thiago Santos Garces, Açucena Leal de Araújo, George Jó Bezerra Sousa and 8 others
PMID 38362842WHAT IT FOUND
Computerized decision support for diabetic foot is widely studied, but this review found little evidence it improves patient outcomes.
It mainly maps screening, prediction, diagnosis and treatment tools.
Key findings
01The review included 23 studies of computerized decision support tools for diabetic foot, covering screening, risk prediction, diagnosis, severity classification and treatment decisions.
02The systems were associated with guideline-based practices, improved spending on treatments and interventions, risk factor management, screening and preventive strategies, but evidence of effectiveness in clinical outcomes was scant.
03The main limitations were too few studies in patients at risk, testing in limited settings, professional resistance, and incomplete database information.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review maps evidence rather than testing whether DSS improve clinical outcomes. Most included studies were observational, and many were tested in limited settings rather than the target high-risk patients. The studies were heterogeneous, so results could not be directly compared or combined. Authors said it was difficult to understand how DSS were applied in context and what they contributed to practice. Evidence of effectiveness in clinical outcomes was scant.
The easy way to misread this
Do not conclude that diabetic foot decision support systems prevent ulcers, amputation or death. This scoping review maps tools and reported scant evidence of effectiveness in clinical outcomes.