Risk stratification systems for XXXX : a systematic review.

@entity1095 @entity1 @entity5109 @entity6 @entity1066 @entity3949 @entity4760
AIMS/HYPOTHESIS: Several risk stratification systems have been proposed for predicting development of @entity4760 . However, little has been published that assesses their similarities and disparities, diagnostic accuracy and evidence level. Consequently, we conducted a systematic review of the existing stratification systems. METHODS: We searched the MEDLINE database for studies (published until April 2010) describing the creation and validation of risk stratification systems for prediction of @entity4760 development. RESULTS: We included 13 studies describing or evaluating the following different risk degree stratification systems: University of Texas; International Working Group on @entity6 Foot; Scottish Intercollegiate Guideline Network (SIGN); American @entity6 Association; and Boyko and colleagues. We confirmed that five variables were included in almost all the systems: @entity3949 , @entity1095 , @entity5109 , and previous foot @entity1066 and amputation. The number of variables included ranged from four to eight and the number of risk groups from two to six. Only four studies reported or allowed the calculation of diagnostic accuracy measures. The SIGN system showed some higher diagnostic accuracy values, particularly positive likelihood ratio, while predictive ability was confirmed through external validation only in the system of Boyko et al. CONCLUSIONS/INTERPRETATION: Foot @entity1066 risk stratification systems are a much needed tool for screening @entity1 with @entity6 . The core variables of various systems are very similar, but the number of included variables in each model and risk groups varied greatly. Overall, the quality of evidence for these systems is low, as little validation of their predictive ability has been done.
