Authors' recommendations: TAP did not identify review-worthy primary research on primary foot care as originally identified for this overview. Discussions with Podiatry Service agreed that a catalog of systematic reviews would meet their needs for an evaluation of the evidence base supporting routine interventions.Some included reviews did ultimately address Podiatry’s original toenail and callus issues, but only in context of control interventions for research designed to address other questions. As indicated above, diabetic foot and other wounds, major burdens for individuals and health care systems, are subjects for the majority of available reviews. Beyond burden of disease, the reviews cataloged here cover ranges of interventions and patient groups so wide that they defy summarization.However, some common themes do emerge: the evidence base does not support firm conclusions on the efficacy of many podiatry interventions; and there are few reliably effective strategies for diabetic foot ulcers, although new technologies may hold promise. In this context, reviewers frequently fall back on “suggestions” from individual methodologically poor and short term studies.Finally, while economic evaluations have been published, the questionable documentation of efficacy makes such analyses premature: those reported here meet minimal standards for inclusion, but rely on efficacy information from small numbers of uncritically selected primary studies.More rigorously conducted and transparently reported research is urgently needed: TAP searched AHRQ’s database (www.clinicaltrials.gov) of ongoing trials using “foot health” on November 10, 2009: of 179 ongoing studies, 16 will add additional if not definitive evidence to the review topics covered here. VHA’s Podiatry Service may consider conducting or supporting its own research and TAP will continue to monitor the podiatry literature.

Project Status: Completed

URL for project: http://www4.va.gov/VATAP/docs/Podiatryupgrade2010.pdf

Year Published: 2009

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: VA Technology Assessment Program

Contact Address: Liz Adams, VA Technology Assessment Program, Office of Patient Care Services (11T), VA Boston Healthcare System Room 4D-142, 150 South Huntington Avenue, Boston, MA 02130 USA Tel: +1 617 278 4469; Fax: +1 617 264 6587;

Contact Name: elizabeth.adams@med.va.gov

Contact Email: elizabeth.adams@med.va.gov

Copyright: VA Technology Assessment Program (VATAP)