Comparing the Incidence of Lower Extremity Amputations Across the World: the Global Lower Extremity Amputation Study

Abstract

A substantial proportion of lower extremity amputations (LEAs), particularly in people with diabetes, are thought to be preventable by the provision of appropriate health care. Information on the incidence of LEAs which is accurate, up-to-date, and comparable cross-sectionally and longitudinally is essential to guide and monitor interventions aimed at their prevention. Current information on the incidence of LEAs is limited and differences between studies in case definition, presentation of rates, level of ascertainment, and population age structure often make meaningful comparisons impossible. To remedy this situation the global LEA study has been established. The study is designed to compare the incidence of LEAs over time within and between communities across the world. The methodology includes adherence to a standard definition of LEA, standardized methods of data collection with built-in quality control, and correction for under-ascertainment of cases (using capture-recapture methodology). Centres wishing to take part in the study must be able to identify a study population of at least 250,000, have reasonably up-to-date population numbers by age and sex, and be prepared to stay in the study for at least 2 years. A study registration form (Appendix 1) is provided.