Podiatry
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Item Encouraging GPs to complete postal questionnaires-one big prize or many small prizes? A randomized controlled trial(2004-12) Thomson, Colin E.; Paterson-Brown, S.; Russell, D.; McCaldin, D.; Russell, I.Background. Low response rates to surveys are a problem in general practice. There is evidence that offering GPs incentives improves response rates to postal questionnaires. However, there is less evidence about the most effective form of incentive. Objective. Our trial aimed to maximize response to a postal questionnaire and to test the most effective form of incentive. Methods. The study involved a randomized controlled trial of a postal survey Results. The incentive of a lottery for six bottles of champagne generated a response rate of 79%. Furthermore, one chance of six bottles generated 9% more responses than six chances of one bottle. Conclusions. This study has established that, among incentives for postal questionnaires, one big prize improves the yield more than many small prizes despite the lower odds of winning. It has also confirmed that offering a modest incentive to GPs generates good response rates for postal questionnairesItem Honey dressing versus paraffin tulle gras following toenail surgery(2006) McIntosh, C.; Thomson, Colin E.Objective: Anecdotal reports suggest that certain honey dressings have a positive effect on wound healing. However, there is limited empirical evidence supporting its use. This double-blind randomised controlled trial investigated the effect of a honey dressing on wound healing following toenail surgery with matrix phenolisation. Method: Participants (n=100) were randomly assigned to receive either an active manuka honey dressing (n=52) or paraffin-impregnated tulle gras (n=48). The primary outcome was time (days) taken for complete re-epithelialisation of the nail bed. Results: Mean healing times were 40.30 days (SD 18.21) for the honey group and 39.98 days (SD 25.42) for the paraffin tulle gras group. Partial avulsion wounds healed statistically significantly faster (p=0.01) with paraffin tulle gras (19.62 days, SD 9.31) than with the honey dressing (31.76 days, SD 18.8), but no significant difference (p=0.21) was found following total avulsion when comparing honey (45.28 days, SD 18.03.) with paraffin tulle gras dressings (52.03 days, SD 21.3). Conclusion: The results suggest that patients may benefit more from paraffin tulle gras dressings than honey dressings following partial toenail avulsion. No statistically significant difference was found for healing times after total toenail avulsion, although the marginal benefit of the honey dressing on these healing times warrants further investigationItem Arthrodesis or total replacement arthroplasty for hallux rigidus: a randomized controlled trial(American Orthopaedic Foot and Ankle Society, Inc., 2005) Gibson, J. N. A.; Thomson, Colin E.Item Economic evaluation of ingrown toenail surgery in Scotland(Springer, 2006) Graham, B.; Dench, H.; Thomson, Colin E.; Russell, I. T.Item Interventions for treating Morton's neuroma: a systematic review(2004) Thomson, Colin E.; Martin, D. J.; Gibson, J. N. A.Background Morton's neuroma is a common, paroxysmal neuralgia affecting the web spaces of the toes, typically the third. The pain is often so debilitating that patients become anxious about walking or even putting their foot to the ground. Insoles, corticosteroid injections, excision of the nerve, transposition of the nerve and neurolysis of the nerve are commonly used treatments. Their effectiveness is poorly understood. Objectives To examine the evidence from randomised controlled trials concerning the effectiveness of interventions in adults with Morton's neuroma. Search strategy We searched the Cochrane Neuromuscular Disease Group trials register (searched January 2003), MEDLINE (January 1966 to January Week 2 2003), EMBASE (January 1980 to February Week 2 2003), and CINAHL (January 1982 to February Week 1 2003). Selection criteria Randomised or quasi-randomised (methods of allocating participants to an intervention which were not strictly random e.g. date of birth, hospital record, number alternation) controlled trials of interventions for Morton's neuroma were selected. Studies where participants were not randomised into intervention groups were excluded. Data collection and analysis Two reviewers selected trials for inclusion in the review, assessed their methodological quality and extracted data independently. Main results Three trials involving 121 people were included. There is, at most, a very limited indication that transposition of the transected plantar digital nerve may yield better results than standard resection of the nerve in the long term. There is no evidence to support the use of supinatory insoles. There are, at best, very limited indications to suggest that dorsal incisions for resection of the plantar digital nerve may result in less symptomatic post-operative scars when compared to plantar excision of the nerve. Authors' conclusions There is insufficient evidence with which to assess the effectiveness of surgical and non-surgical interventions for Morton's neuroma. Well designed trials are needed to begin to establish an evidence base for the treatment of Morton's neuroma pain.Item Consumer health information on the WWW: An evaluation of information on verrucae(2003-07-19) Ellis, Mairghread JH; Thomson, Colin E.Background: Increasingly the World Wide Web (WWW) is used as a first source by individuals seeking health information, and it is actively promoted as an information source by the NHS. Objective: This study evaluated the accessibility and quality of WWW-based information about verrucae, a condition where podiatrists often encourage self-treatment. Method: Using the term verruca- a variety of searches were undertaken. Outcome measures- - quality scores for information according to developed criteria; - presence of the Health on the Net Foundation (HONcode logo), to indicate quality of website. Results: Twenty-three sites were evaluated. Overall, quality of information was low, due to lack of information, rather than inaccuracy. Consumer health websites returned the highest mean scores for information quality. Sites of academic/professional and commercial ownership contained a higher quality of information than privately owned, or NHS-owned. Three sites (13%) displayed the Health on the Net Foundation logo, indicating adherence to their ethical standards. Conclusions: Results suggest that while relevant information is available on the WWW, it is not always easy to locate. It is essential to use appropriate search terms, and to appraise every site. Healthcare practitioners may have a role to play in guiding consumers towards effective search strategies, thus ensuring safe, relevant information is accessed.Item 50+ Foot Challenges: Assessment and Evidence-Based Management(Elsevier, 2009) Thomson, Colin E.; Gibson, J. N. A.The new 50+ Foot Challenges: Assessment and Evidence-based management retains all the benefits of the popular first edition but adds more cases, more illustrations, new sections and invaluable appendices. The same illustrated case-history format as in the first edition presents readers with the clinical problems of each disorder. In each case, a problem-solving approach is encouraged through a question-and-answer format. This guides the reader to the appropriate diagnosis and treatment plan. Clinical tips for improving practice are included and each study concludes with a short list of key points and references to further reading. All those involved in the care and management of patients with foot conditions will find this book an invaluable aide-memoire and guide to their daily practice.Item The effectiveness of extra corporeal shock wave therapy for plantar heel pain : a systematic review and meta-analysis(BioMed Central, 2005-04-22) Thomson, Colin E.; Crawford, Fay; Murray, GordonBackground There is considerable controversy regarding the effectiveness of extracorporeal shock wave therapy in the management of plantar heel pain. Our aim was to conduct a systematic review of randomised controlled trials to investigate the effectiveness of extracorporeal shock wave therapy and to produce a precise estimate of the likely benefits of this therapy. Methods We conducted a systematic review of all randomised controlled trials (RCTs) identified from the Cochrane Controlled trials register, MEDLINE, EMBASE and CINAHL from 1966 until September 2004. We included randomised trials which evaluated extracorporeal shock wave therapy used to treat plantar heel pain. Trials comparing extra corporeal shock wave therapy with placebo or different doses of extra corporeal shock wave therapy were considered for inclusion in the review. We independently applied the inclusion and exclusion criteria to each identified randomised controlled trial, extracted data and assessed the methodological quality of each trial. Results Six RCTs (n = 897) permitted a pooled estimate of effectiveness based on pain scores collected using 10 cm visual analogue scales for morning pain. The estimated weighted mean difference was 0.42 (95% confidence interval 0.02 to 0.83) representing less than 0.5 cm on a visual analogue scale. There was no evidence of heterogeneity and a fixed effects model was used. Conclusion A meta-analysis of data from six randomised-controlled trials that included a total of 897 patients was statistically significant in favour of extracorporeal shock wave therapy for the treatment of plantar heel pain but the effect size was very small. A sensitivity analysis including only high quality trials did not detect a statistically significant effect.