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The 2011 Australian DFD guidelines were outdated. We aimed to develop methodology for systematically adapting suitable international guidelines to the Australian context to become the new Australian evidence\u2010based guidelines for DFD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We followed the Australian National Health Medical Research Council (NHMRC) guidelines for adapting guidelines. We systematically searched for all international DFD guideline records. All identified records were independently screened and assessed for eligibility. Those deemed eligible were further assessed and included if scoring at least moderate quality, suitability and currency using AGREE II and NHMRC instruments. The included international guidelines had all recommendations extracted into six sub\u2010fields: prevention, wound classification, peripheral artery disease, infection, offloading and wound healing. Six national panels, each comprising 6\u20138\u00a0multidisciplinary national experts, screened all recommendations within their sub\u2010field for acceptability and applicability in Australia using an ADAPTE form. Where panels were unsure of any acceptability and applicability items, full assessments were undertaken using a GRADE Evidence to Decision tool. Recommendations were adopted, adapted, or excluded, based on the agreement between the panel's and international guideline's judgements. Each panel drafted a guideline that included all their recommendations, rationale, justifications, and implementation considerations. All underwent public consultation, final revision, and approval by national peak bodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We screened 182 identified records, assessed 24 full text records, and after further quality, suitability, and currency assessment, one record was deemed a suitable international guideline, the International Working Group Diabetic Foot Guidelines (IWGDF guidelines). The six panels collectively assessed 100 IWGDF recommendations, with 71 being adopted, 27 adapted, and two excluded for the Australian context. We received 47 public consultation responses with &gt;\u200980% (strongly) agreeing that the guidelines should be approved, and ten national peak bodies endorsed the final six guidelines. The six guidelines and this protocol can be found at: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.diabetesfeetaustralia.org\/new-guidelines\/\">https:\/\/www.diabetesfeetaustralia.org\/new\u2010guidelines\/<\/jats:ext-link><\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>New Australian evidence\u2010based guidelines for DFD have been developed for the first time in a decade by adapting suitable international guidelines. The methodology developed for adaptation may be useful for other foot\u2010related conditions. These new guidelines will now serve as the national multidisciplinary best practice standards of DFD care in Australia.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13047-022-00533-8","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T07:16:57Z","timestamp":1650352617000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Guidelines development protocol and findings: part of the 2021 Australian evidence\u2010based guidelines for diabetes\u2010related foot disease"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-7964","authenticated-orcid":false,"given":"Peter A.","family":"Lazzarini","sequence":"first","affiliation":[{"name":"School of Public Health and Social Work Queensland University of Technology Brisbane Australia"},{"name":"Allied Health Research Collaborative The Prince Charles Hospital Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Raspovic","sequence":"additional","affiliation":[{"name":"School of Allied Health Human Services and Sport College of Science Health &amp; Engineering La Trobe University Bundoora Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Prentice","sequence":"additional","affiliation":[{"name":"Hall and Prior Health and Aged Care Group Perth Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Commons","sequence":"additional","affiliation":[{"name":"Global Health Division Menzies School of Health Research Charles Darwin University Darwin Northern Territory Australia"},{"name":"Internal Medicine Services Ballarat Health Services Ballarat Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A.","family":"Fitridge","sequence":"additional","affiliation":[{"name":"Discipline of Surgery The University of Adelaide Adelaide Australia"},{"name":"Vascular and Endovascular Service Royal Adelaide Hospital Adelaide Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Charles","sequence":"additional","affiliation":[{"name":"First Peoples Health Unit Faculty of Health Griffith University Gold Coast Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Cheney","sequence":"additional","affiliation":[{"name":"Diabetes Victoria Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nytasha","family":"Purcell","sequence":"additional","affiliation":[{"name":"Diabetes Feet Australia Brisbane Australia"},{"name":"Australian Diabetes Society Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen M.","family":"Twigg","sequence":"additional","affiliation":[{"name":"Sydney Medical School (Central) Faculty of Medicine and Health University of Sydney Sydney Australia"},{"name":"Department of Endocrinology Royal Prince Alfred Hospital Camperdown Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Australian Diabetes\u2010related Foot Disease Guidelines & Pathways Project","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,4,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja17.01198"},{"key":"e_1_2_12_3_1","volume-title":"Australian diabetes\u2010related foot disease strategy 2018\u20132022: the first step towards ending avoidable amputations within a generation","author":"Netten JJ","year":"2017"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19\u20101614"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047\u2010021\u201000447\u2010x"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3268"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(16)30012\u20102"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0130609"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2015.02.008"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933\u2010015\u20100315\u2010z"},{"key":"e_1_2_12_11_1","volume-title":"National evidence\u2010based guideline on prevention, identification and management of foot complications in diabetes (Part of the National Health & Medical Research Council Approved Guidelines on Management of Type 2 Diabetes)","author":"Baker IDI Heart and Diabetes Institute","year":"2011"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3101"},{"key":"e_1_2_12_13_1","unstructured":"National Health & Medical Research Council (NHMRC).Australian Clinical Practice Guidelines Portal Search Canberra Australia 2020[Available from:https:\/\/www.clinicalguidelines.gov.au\/portal accessed on 13 Dec 2021]."},{"key":"e_1_2_12_14_1","unstructured":"National Health & Medical Research Council (NHMRC).Guidelines for Guidelines: Adopt adapt or start from scratch \u2010 Version 5.2; 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PAL, AR, RAF were part of the development of the 2019 IWGDF guidelines as co-authors of the offloading, prevention and PAD IWGDF Guidelines and Systematic Reviews respectively, that served as the international source guidelines in which the \u201c2021 Australian evidence-based guidelines for diabetes-related foot disease\u201d were adapted. PAL has also been a speaker consultant with Sanofi Australia, is chair of Diabetes Feet Australia, and a member of the Journal of Foot & Ankle Editorial Board, National Association of Diabetes Centres Foot Network Committee, Australian Foot Forward Project Committee and Aboriginal and Torres Strait Islander Diabetic Foot Complications Program Expert Advisory Committee. AR is a member of the Journal of Foot & Ankle Editorial Board. JChe is employed by Diabetes Victoria and is fully funded by the National Diabetes Services Scheme. Otherwise, all other authors declare that they have no relevant competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"28"}}