Timing of access to secondary healthcare services for diabetes management and lower extremity amputation in people with diabetes: a protocol of a case-control study.

Buckley, Claire M; Ali, Fauzi; Roberts, Graham; Kearney, Patricia M; Perry, Ivan J; Bradley, Colin P

dc.contributor.author	Buckley, Claire M
dc.contributor.author	Ali, Fauzi
dc.contributor.author	Roberts, Graham
dc.contributor.author	Kearney, Patricia M
dc.contributor.author	Perry, Ivan J
dc.contributor.author	Bradley, Colin P
dc.date.accessioned	2015-09-09T09:41:20Z	en
dc.date.available	2015-09-09T09:41:20Z	en
dc.date.issued	2013-09-03	en
dc.identifier.citation	Timing of access to secondary healthcare services for diabetes management and lower extremity amputation in people with diabetes: a protocol of a case-control study. 2013, 3 (10):e003871 BMJ Open	en
dc.identifier.issn	2044-6055	en
dc.identifier.pmid	24171939	en
dc.identifier.doi	10.1136/bmjopen-2013-003871	en
dc.identifier.uri	http://hdl.handle.net/10147/576988	en
dc.description	Lower extremity amputation (LEA) is an important complication of diabetes mellitus. National and global LEA rates vary for reasons such as ethnicity, case definition, and ascertainment of diabetes prevalence.	en
dc.description.abstract	Lower extremity amputation (LEA) is a complication of diabetes and a marker of the quality of diabetes care. Clinical and sociodemographic determinants of LEA in people with diabetes are well known. However, the role of service-related factors has been less well explored. Early referral to secondary healthcare is assumed to prevent the occurrence of LEA. The objective of this study is to investigate a possible association between the timing of patient access to secondary healthcare services for diabetes management, as a key marker of service-related factors, and LEA in patients with diabetes.
dc.description.abstract	This is a case-control study. The source population is people with diabetes. Cases will be people with diabetes who have undergone a first major LEA, identified from the hospital discharge data at each of three regional centres for diabetes care. Controls will be patients with diabetes without LEA admitted to the same centre either electively or as an emergency. Frequency-matching will be applied for gender, type of diabetes, year and centre of LEA. Three controls per case will be selected from the same population as the cases. With a power of 90% to detect OR of 0.4 for an association between 'good quality care' and LEA in people with diabetes, 107 cases and 321 controls are required. Services involved in diabetes management are endocrinology, ophthalmology, renal, cardiology, vascular surgery and podiatry; timing of first contact with any of these services is the main exploratory variable. Using unconditional logistic regression, an association between this exposure and the outcome of major LEA in people with diabetes will be explored, while adjusting for confounders.
dc.description.abstract	Ethical approval was granted by the Clinical Research Ethics Committee of the Cork Teaching Hospitals, Ireland. Results will be presented at conferences and published in peer-reviewed journals.
dc.language.iso	en	en
dc.publisher	BMJ Open	en
dc.rights	Archived with thanks to BMJ open	en
dc.subject	DIABETES MELLITUS	en
dc.subject	AMPUTATION	en
dc.title	Timing of access to secondary healthcare services for diabetes management and lower extremity amputation in people with diabetes: a protocol of a case-control study.	en
dc.type	Article	en
dc.identifier.journal	BMJ Open	en
refterms.dateFOA	2018-08-27T08:52:24Z
html.description.abstract	Lower extremity amputation (LEA) is a complication of diabetes and a marker of the quality of diabetes care. Clinical and sociodemographic determinants of LEA in people with diabetes are well known. However, the role of service-related factors has been less well explored. Early referral to secondary healthcare is assumed to prevent the occurrence of LEA. The objective of this study is to investigate a possible association between the timing of patient access to secondary healthcare services for diabetes management, as a key marker of service-related factors, and LEA in patients with diabetes.
html.description.abstract	This is a case-control study. The source population is people with diabetes. Cases will be people with diabetes who have undergone a first major LEA, identified from the hospital discharge data at each of three regional centres for diabetes care. Controls will be patients with diabetes without LEA admitted to the same centre either electively or as an emergency. Frequency-matching will be applied for gender, type of diabetes, year and centre of LEA. Three controls per case will be selected from the same population as the cases. With a power of 90% to detect OR of 0.4 for an association between 'good quality care' and LEA in people with diabetes, 107 cases and 321 controls are required. Services involved in diabetes management are endocrinology, ophthalmology, renal, cardiology, vascular surgery and podiatry; timing of first contact with any of these services is the main exploratory variable. Using unconditional logistic regression, an association between this exposure and the outcome of major LEA in people with diabetes will be explored, while adjusting for confounders.
html.description.abstract	Ethical approval was granted by the Clinical Research Ethics Committee of the Cork Teaching Hospitals, Ireland. Results will be presented at conferences and published in peer-reviewed journals.