{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:36:24Z","timestamp":1785458184791,"version":"3.56.0"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001348","name":"Agency for Science, Technology and Research","doi-asserted-by":"publisher","award":["H19\/01\/a0\/PP9"],"award-info":[{"award-number":["H19\/01\/a0\/PP9"]}],"id":[{"id":"10.13039\/501100001348","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Present guidelines recommend a multidisciplinary team (MDT) approach to diabetic foot ulcer (DFU) care, but relevant data from Asia are lacking. We aim to evaluate the clinical and economic outcomes of an MDT approach in a lower extremity amputation prevention programme (LEAPP) for DFU care in an Asian population. We performed a case\u2010control study of 84 patients with DFU between January 2017 and October 2017 (retrospective control) vs 117 patients with DFU between December 2017 and July 2018 (prospective LEAPP cohort). Comparing the clinical outcomes between the retrospective cohort and the LEAPP cohort, there was a significant decrease in mean time from referral to index clinic visit (38.6 vs 9.5\u2009days,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u2009.001), increase in outpatient podiatry follow\u2010up (33% vs 76%,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u2009.001), decrease in 1\u2010year minor amputation rate (14% vs 3%,\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a0.007), and decrease in 1\u2010year major amputation rate (9% vs 3%,\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a0.05). Simulation of cost avoidance demonstrated an annualised cost avoidance of USD $1.86m (SGD $2.5m) for patients within the LEAPP cohort. In conclusion, similar to the data from Western societies, an MDT approach in an Asian population, via a LEAPP for patients with DFU, demonstrated a significant reduction in minor and major amputation rates, with annualised cost avoidance of USD $1.86m.\n                  <\/jats:p>","DOI":"10.1111\/iwj.13672","type":"journal-article","created":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T01:51:21Z","timestamp":1628301081000},"page":"765-773","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Clinical and economic outcomes of a multidisciplinary team approach in a lower extremity amputation prevention programme for diabetic foot ulcer care in an\n                    <scp>Asian<\/scp>\n                    population: A case\u2010control study"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2289-5266","authenticated-orcid":false,"given":"Zhiwen Joseph","family":"Lo","sequence":"first","affiliation":[{"name":"Vascular Surgery Service, Department of General Surgery Tan Tock Seng Hospital  Singapore"},{"name":"Lee Kong Chian School of Medicine Centre for Population Health Sciences Nayang Technological University  Singapore"},{"name":"Skin Research Institute of Singapore Agency for Science, Technology and Research  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadhana","family":"Chandrasekar","sequence":"additional","affiliation":[{"name":"Vascular Surgery Service, Department of General Surgery Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enming","family":"Yong","sequence":"additional","affiliation":[{"name":"Vascular Surgery Service, Department of General Surgery Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiantai","family":"Hong","sequence":"additional","affiliation":[{"name":"Vascular Surgery Service, Department of General Surgery Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[{"name":"Vascular Surgery Service, Department of General Surgery Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lester Rhan Chaen","family":"Chong","sequence":"additional","affiliation":[{"name":"Vascular Surgery Service, Department of General Surgery Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn","family":"Tan","sequence":"additional","affiliation":[{"name":"Vascular Surgery Service, Department of General Surgery Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yam Meng","family":"Chan","sequence":"additional","affiliation":[{"name":"Vascular Surgery Service, Department of General Surgery Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui Yan","family":"Koo","sequence":"additional","affiliation":[{"name":"Vascular Surgery Service, Department of General Surgery Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Chew","sequence":"additional","affiliation":[{"name":"Department of Podiatry Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur Faezah","family":"Sani","sequence":"additional","affiliation":[{"name":"Department of Podiatry Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keet Yeng","family":"Cheong","sequence":"additional","affiliation":[{"name":"Department of Podiatry Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leighton Ren Qin","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Podiatry Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey Hui Min","family":"Tan","sequence":"additional","affiliation":[{"name":"Wound and Stoma Care, Nursing Specialty Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivakami","family":"Muthuveerappa","sequence":"additional","affiliation":[{"name":"Wound and Stoma Care, Nursing Specialty Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina Peiting","family":"Lai","sequence":"additional","affiliation":[{"name":"Wound and Stoma Care, Nursing Specialty Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng Cheng","family":"Goh","sequence":"additional","affiliation":[{"name":"Wound and Stoma Care, Nursing Specialty Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary Y.","family":"Ang","sequence":"additional","affiliation":[{"name":"Health Services and Outcomes Research National Healthcare Group  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhecheng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Health Services and Outcomes Research National Healthcare Group  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Han","family":"Hoi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Woodlands Health Campus  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime H. X.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Woodlands Health Campus  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E. K.","family":"Chew","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei Shan","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0956-5759","authenticated-orcid":false,"given":"Huiling","family":"Liew","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Tan Tock Seng Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2017.151"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v7.i7.153"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182081"},{"key":"e_1_2_9_5_1","unstructured":"National Institute for Health and Care Excellence Clinical Guideline (CG147).Peripheral arterial disease: diagnosis and management. February 21 2018.https:\/\/www.nice.org.uk\/guidance\/cg147Accessed August 20 2020."},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.216"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2017.07.007"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13333"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13540"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-1178"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2015.10.003"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-016-0111-0"},{"key":"e_1_2_9_13_1","unstructured":"IWGDF guidelines on the prevention and management of diabetic foot disease.2019.https:\/\/iwgdfguidelines.org\/wp-content\/uploads\/2019\/05\/IWGDF-Guidelines-2019.pdf. Accessed August 20 2020."},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/383275"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.8.1240"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.06.003"},{"key":"e_1_2_9_17_1","unstructured":"National Healthcare Group Corporate Yearbook 2019 FY2018;Page 134.https:\/\/corp.nhg.com.sg\/Lists\/Corporate%20Year%20Book\/Attachments\/67\/NHG%20Yearbook%202019%20Lowres%20Single1.pdf. Accessed June 2021."},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/sja.SJA_543_18"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.3402\/dfa.v1i0.5731"},{"issue":"9","key":"e_1_2_9_20_1","first-page":"666","article-title":"Lower extremity amputation prevention in Singapore: economic analysis of results","volume":"52","author":"Tan MLM","year":"2011","journal-title":"Singapore Med J"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-021-05441-3"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1393966"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2007.01608.x"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002648"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.7547\/0980489"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2016.11.020"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13054"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9136(199611)13:11<967::AID-DIA266>3.0.CO;2-K"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-012-2673-3"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2007.01367.x"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.08.244"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-020-0380-8"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-019-05020-7"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-020-00383-2"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12545"},{"issue":"3","key":"e_1_2_9_37_1","first-page":"44","article-title":"A multidisciplinary approach for the management of diabetic foot ulcers","volume":"9","author":"Zielinski M","year":"2018","journal-title":"Wounds Int"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.06.003"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.11.032"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2017.26.6.324"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1080\/2000625X.2018.1452513"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.13672","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iwj.13672","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.13672","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T02:10:14Z","timestamp":1770948614000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.13672"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,6]]},"references-count":40,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1111\/iwj.13672"],"URL":"https:\/\/doi.org\/10.1111\/iwj.13672","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,6]]},"assertion":[{"value":"2021-06-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}