clinics in podiatry

Authors have a wide range of journals to which they can submit their report for consideration for publication. One key to getting the journal editors to accept a report is that the manuscript is properly organized and in compliance with the journal's Guide for Authors. For this reason, the single most important undertaking that an author can do before submission is read the journal's Guide for Authors and make sure that the report meets the journal's requirements for publication. If the subject matter is interesting and scientifically rigorous, then a well-written manuscript that complies with the journal's requirements will likely cruise through the peer review process and get accepted for publication...

In 1992, I completed a 9-year dual-degree program where I received both my DPM degree and a PhD in Bioengineering. Upon my graduation, it was apparent that "Industry" had an interest in me. Sponsored research and consulting opportunities where readily available, and I had to learn very quickly to sort the scientific from the sham, and the clinically worthwhile from the worthless. Partnering with Industry has provided me with another avenue to advance my profession, while helping to develop new treatment options that can potentially help many more patients then just the ones I see in my office...

The objective of this article is to provide a brief overview of the critical analysis and design of unique and perhaps less common methodologies in podiatric science. These include basic science translational designs, cadaveric investigations, gait analyses, dermatologic studies, and database analysis. The relative advantages, disadvantages, and inherent limitations are reviewed with an intention to improve the interpretation of results and advance future foot and ankle scientific endeavors.

In the past 30 years, there has been a rapid influx of information pertaining to the diabetic foot (DF) coming from numerous directions and sources. This article discusses the current state of the DF literature and challenges it presents to clinicians with its associated increase in knowledge on their derivations, complications, and interventions. Further, we attempt to provide tips on how to navigate and criticize the current literature to encourage and maximize positive outcomes in this challenging patient population...

A cost-effectiveness analysis (CEA) is a type of health economics model that uses a systematic approach to simplify the complexities that exist in health-care decision-making. A CEA aids in medical decision-making by considering both the costs of a treatment and how effective that treatment is for at least 2 competing strategies. This article reviews major concepts of CEA including results interpretation, key attributes of CEA that make it differ from cost analysis, uncertainty surrounding analysis, and how/why CEA is an important contributor to the medical literature...

Evidence synthesis is a complex approach to research that can consolidate the current understanding of a particular topic from various sources. A design hierarchy based upon reliability is described in detail. Methodology is described explicitly to provide readers with a foundation for performing and understanding published evidence synthesis. Resources that detail access to the comprehensive database are presented and explained. Special care is taken to discuss appraisal of studies prior to analysis.

A well-conducted prospective cohort study has the potential to change the way in which surgeons practice. However, not all are equal. In this article, we provide many of the tools needed to critically appraise this powerful study design. We advocate for using a 3-step approach that centers on understanding the study's generalizability, results, and validity. We illustrate how this process is applied into practice regularly at our hospital section's journal club sessions.

Retrospective studies represent an often used research methodology in the podiatric scientific literature, with cohort studies and case series being two of the most prevalent designs. Choosing a retrospective method is often dependent on multiple factors, two of the most important being details of the research question to be explored and the sample size that can be acquired. When analyzing literature, a reader must understand how retrospective studies work to critically examine the methods, results, and discussions to determine if the conclusion is reasonable and might be applied to clinical practice...

Once the mainstay of scientific journals, in the age of evidence-based medicine, case reports and small series are now considered to represent a lower hierarchy in the medical decision-making process. However, case reports and small series represent the culmination of the time-honored traditional medical education teaching method with the descriptive case presentation. Despite being infrequently cited as references, case reports and small series still offer important contributions to patient care. The authors present a review of the strengths and weaknesses of case reports and small series and discuss ways to incorporate this form of literature into structured medical education...

Having reasonable outcome measures is essential to unbiased research. For years, provider-measured outcomes have been valued as they are more objective and convenient for investigators. However, with the popularity of patient-centered medical care delivery, patient-reported outcome measures are appropriately becoming more popular in foot and ankle research.

Evidence-based research is essential to improving podiatric medicine and surgery; however, there are many barriers to conducting research, with a major limitation being lack of research funding. There are various grants and funding sources available to podiatric surgeon scientists, but navigating through the resources can be daunting. In this article, we provide a framework for grant writing and funding opportunities for podiatric surgeons to consider.

Obtaining institutional review board (IRB) approval can be an overwhelming task, especially for new researchers. IRB approval can require many documents and steps. It is important to start the submission early, have patience throughout the process, and determine what can help expedite the process. Research cannot begin without IRB approval, which is necessary when working with human subjects. Ultimately, the researchers and IRB have the same goal of enabling good research with minimal subject risk. The goal of this article is to give an overview of the IRB for practitioners performing research in podiatric medicine and surgery...

Treating patients in clinic can be busy and stressful; however, utilization of well-planned strategic workflows that include the proper information for research studies can result in daily prospective data collection that will be subsequently amenable to retrospective analysis.

Statistics is a set of tools used in medical decision-making no different than how a scalpel or a sagittal saw is used in the operating room. No foot and ankle surgeon is born with the inherent ability to perform, understand, and critically interpret them. Instead, it requires training and practice throughout the course of a career in medicine to develop a working proficiency. This article reviews the basic indications and interpretation of common descriptive and comparative statistical tests in the podiatric literature...

Critical analysis of the medical literature and an evidence-based approach to clinical practice and medical decision-making is of vital importance in contemporary podiatric practice. This article reviews the levels of clinical evidence and their application within this paradigm. This includes determining which level of evidence is most appropriate for a given methodology, as well as an appreciation of inherent limitations within each level of evidence. The article concludes with a discussion on the difference between statistical significance and clinical significance...

This retrospective cohort study aims to assess whether the implementation of a multidisciplinary approach in the Gosford Hospital High-Risk Foot Clinic improved outcomes of diabetic foot ulcers. Ulceration is a common foot complication of diabetes mellitus and greatly increases patient morbidity and mortality. Patients who attended at least one appointment at the Gosford Hospital High-Risk Foot Clinic in 2017 or 2019 were identified through the Gosford Hospital Podiatry department's records. The 2017 and 2019 cohorts were compared on measures of ulcer healing, incidence of amputation, incidence of vascular intervention and surgical debridement, percentage of patients admitted to hospital due to complications and use of systemic antibiotic therapy...

The toenail unit, commonly called the nail, is one of the most frequently examined and treated structures in clinical podiatry. Ultrasound is a standard clinical technique because it is a noninvasive, painless, and rapid diagnostic tool. The main objective of this study was to obtain morphometric data of the healthy toenail unit by ultrasound for clinical application. The nails of 76 participants (152 hallux nails; 38 men, 38 women, average age 26.83 ± 12.20) were examined using a VINNO E35 ultrasound system and an X6-16L linear probe with a frequency of 18 MHz...

BACKGROUND: Neuropathic foot ulcers are the leading cause of nontraumatic foot amputations, particularly among patients with diabetes. Traditional methods of monitoring and managing these patients are periodic in-person clinic visits, which are passive and may be insufficient for preventing neuropathic foot ulcers and amputations. Continuous remote temperature monitoring has the potential to capture the critical period before the foot ulcers develop and to improve outcomes by providing real-time data and early interventions...

Diabetic foot osteomyelitis (DFO) poses a significant challenge in the management of diabetic patients, often leading to severe complications and increased morbidity. Effective management of DFO requires a multidisciplinary approach, involving endocrinologists, infectious disease specialists, vascular surgeons, orthopaedic surgeons, and wound care experts. Early diagnosis is paramount, facilitated by advanced imaging techniques such as magnetic resonance imaging (MRI) and bone scintigraphy. Once diagnosed, the treatment strategy hinges on a combination of medical and surgical interventions...

BACKGROUNDS: Skin wounds are a kind of refractory disease frequently encountered in clinic, which brings enormous burden to patients. Great efforts to address the dilemma of wound healing have yielded some encouraging results, but they are still unsatisfactory. 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) has been developed as a promising noninvasive treatment for skin wounds. A systematic review was performed to determine the existing evidence base for the clinical use of ALA-PDT on refractory wounds...