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University","doi-asserted-by":"publisher","award":["2022YFS0308"],"award-info":[{"award-number":["2022YFS0308"]}],"id":[{"id":"10.13039\/501100013365","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013365","name":"West China Hospital, Sichuan University","doi-asserted-by":"publisher","award":["ZYGD18025"],"award-info":[{"award-number":["ZYGD18025"]}],"id":[{"id":"10.13039\/501100013365","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Diabetes Research"],"published-print":{"date-parts":[[2022,9,26]]},"abstract":"<jats:p>\n                    Objective. To reduce diabetic foot ulcer (DFU) occurrence or recurrence, diabetic therapeutic footwear is widely recommended in clinical practice for at-risk patients. However, the effectiveness of therapeutic footwear is controversial. Thus, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine whether special therapeutic footwear could reduce the incidence of DFU. Method. We systematically searched multiple electronic databases (Medline, EMBASE, and EMB databases) to identify eligible studies published from inception to June 11, 2021. The database search, quality assessment, and data extraction were independently performed by two reviewers. Efficacy (i.e., incidence of DFU) was explored using the R\u2019meta\u2019 package (version 4.15-1). To obtain more robust results, the random-effects model and the Hartung-Knapp-Sidik-Jonkman method were selected to assess pooled data. Metaregression analysis and sensitivity analysis were performed to explore heterogeneity, and publication bias was assessed by a visual inspection of funnel plots and the AS-Thompson test. Results. Eight RCTs with a total of 1,587 participants were identified from the search strategy. Compared with conventional footwear, special therapeutic footwear significantly reduced the incidence of DFU (RR 0.49; 95% CI, 0.28-0.84), with no evidence of publication bias (\n                    <jats:inline-formula>\n                      <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>P<\/a:mi>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>0.69<\/a:mn>\n                      <\/a:math>\n                    <\/jats:inline-formula>\n                    ). Unexpectedly, the effectiveness of special therapeutic footwear had a reverse correlation with the intervention time (\n                    <jats:inline-formula>\n                      <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mtext>coefficient<\/c:mtext>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.085<\/c:mn>\n                      <\/c:math>\n                    <\/jats:inline-formula>\n                    ,\n                    <jats:inline-formula>\n                      <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>P<\/e:mi>\n                        <e:mo>&lt;<\/e:mo>\n                        <e:mn>0.05<\/e:mn>\n                      <\/e:math>\n                    <\/jats:inline-formula>\n                    ) in the metaregression analysis. Conclusion. Special therapeutic footwear with offloading properties is effective in reducing the incidence of DFU. However, the effect may decrease gradually over time. Despite undefined reasons, the optimal utility time and renewal frequency of special therapeutic footwear should be considered.\n                  <\/jats:p>","DOI":"10.1155\/2022\/9742665","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T19:20:17Z","timestamp":1664220017000},"page":"1-10","source":"Crossref","is-referenced-by-count":27,"title":["Effects of Special Therapeutic Footwear on the Prevention of Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.1155","volume":"2022","author":[{"given":"Bo","family":"Luo","sequence":"first","affiliation":[{"name":"Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuying","family":"Cai","sequence":"additional","affiliation":[{"name":"West China Medical School, Sichuan University, Chengdu, 610041 Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawei","family":"Chen","sequence":"additional","affiliation":[{"name":"Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun","family":"Wang","sequence":"additional","affiliation":[{"name":"Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Huang","sequence":"additional","affiliation":[{"name":"Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihong","family":"Chen","sequence":"additional","affiliation":[{"name":"Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7269-9741","authenticated-orcid":true,"given":"Yun","family":"Gao","sequence":"additional","affiliation":[{"name":"Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6634-1241","authenticated-orcid":true,"given":"Xingwu","family":"Ran","sequence":"additional","affiliation":[{"name":"Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1017\/UPO9781922064004.027"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12263"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2319"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.3310\/hta19570"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-0996"},{"key":"7","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1016\/B978-0-323-29738-7.00033-2","article-title":"Complications of diabetes mellitus","volume-title":"William\u2019s textbook of endocrinology","author":"M. 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