Check out a recent blog post by Dick Clarke, President of National Baromedical Services, Inc, about the American Diabetes Association’s (ADA) “Standards of Medical Care in Diabetes 2020,” assessment of Hyperbaric oxygen therapy for DFUs.
The ADA’s assessment of HBOT was largely based on the discredited Fedorko study, a topic which I blogged about a long time ago.
The endpoint for the Fedorko study was a photographic assessment of whether a foot should be amputated, not whether it actually WAS amputated or ultimately healed. The photo assessment was wrong the vast majority of the time (most patients allocated to “amputation” actually healed), but the real outcomes data were never published.
Here’s a video by a patient who was allocated to the “amputated category,” but who wanted to show that she completely healed with HBOT and was ambulatory.
You can’t make this stuff up. Well, actually, if you are a socialized healthcare system like Canada and don’t want to pay for HBOT, apparently you CAN just make stuff up. That’s food for thought.
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
We desperately need a wound care ontology for diagnosis and treatment utilizing well defined definitions, diagnostic and physical findings, and wound care conceptualizations. To site 2 points, the Wagner DM wound care classification is clearly descriptively inadequate and the ABI is a deeply flawed test with extremely limited prognostic value in wound healing. .