A review of design and reporting issues in self-reported prevalence studies of leg ulceration.
OBJECTIVE
The aim of this review was to examine design and reporting issues that affect prevalence estimates of leg ulceration obtained using self-report and outline strategies to strengthen the validity and reliability of research in this area.


METHODS
We identified leg ulcer prevalence studies and evaluated them against the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. The authors draw upon the wider literature and their own empirical work in discussing strategies to overcome design and reporting issues.


RESULTS
Common deficiencies in the design and reporting of studies include wide variations in diagnostic criteria and age parameters for participant selection, a lack of description of efforts to address bias/study size rationale, and low participation rates in clinical examination stages. These factors and differences in statistical methods of analysis affect the validity and reliability of findings and hinder interpretation, making comparisons across populations difficult. Opportunities for subgroup analyses are frequently missed.


CONCLUSIONS
Self-report is a valuable means of capturing leg ulcer prevalence, but the future design and reporting of studies need to be strengthened, including addressing weaknesses in validation strategies. Capture-recapture analysis or a multiple-methods approach has the potential to yield the most valid and reliable prevalence estimates.
Firth
Jill
J
School of Healthcare, Baines Wing, University of Leeds, Leeds, West Yorkshire, UK. j.firth@leeds.ac.uk
Nelson
Elizabeth Andrea
EA
Hale
Claire
C
Hill
Jacqueline
J
Helliwell
Philip
P
D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007871:Leg Ulcer / Q000191:economics / Q000453:epidemiology*; D008297:Male; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards; D006113:United Kingdom / Q000453:epidemiology