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Epidemiology of major lower limb amputation using routinely collected electronic health data in the UK: a systematic review protocol
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    Epidemiology of lower limb extremity amputations – Do we already have the answer to why there is significant variation in the reporting of incidence, prevalence and number?

    Dear Editor,

    It is interesting to read that Meffen A, et al. (2020) will study the incidence, prevalence and number of major-lower limb amputations in the UK, amongst their objectives. They plan to investigate the reasons for significant variation in the reporting of epidemiology of major lower extremity amputation (LEA). Prevalence of LEA has been evaluated, on numerous occasions in many epidemiological studies (1-14).

    There has been a recent study that has followed similar methods and objectives to Meffen A, et al. (2020), to determine the methodological differences that create the variation of prevalence of LEAs (1). There are also studies that have used robust methodology to report on incidence, prevalence and number of LEAs, which include age standardised, gender, ethnic minority, and regional specific data analysis (6, 13, 14).

    The same systematic searches of peer reviewed journals using PRISMA guidelines, have already been carried out from a comprehensive range of databases: PubMed, Cumulative index to Nursing and Allied Health Literature (CINAHL), ExperptaMedica Database (EMBASE), Medical Literature Analysis and Retrieval Online (MEDLINE), Cochrane database, NHS Digital, Diabetes UK and Healthcare Quality Improvement Partnership (HQIP), of all LEA studies performed in England, over a 30 year period (1988- 2018) (1).

    The variation in prevalence of major LEAs, reported by Davies M, Burdett L, Bowling F, et al. (2019) range from 0.7...

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    Conflict of Interest:
    None declared.