title: Describe the outcomes of dysvascular partial foot amputation and how these compare to transtibial amputation: a systematic review protocol for the development of shared decision-making resources.
abstract: BACKGROUND
  Helping people make well-informed decisions about dysvascular partial foot amputation is becoming increasingly important as improvements in diabetes care and vascular surgery make more distal amputations increasingly possible. The high rates of complications and reamputations associated with partial foot amputation are of concern, particularly given that transtibial amputation seems to result in similar outcomes (e.g., mobility and quality of life) with comparatively few complications and reamputations. The aim of this review is to describe the outcomes of dysvascular partial foot amputation and compare these to transtibial amputation. Results from the review are intended for use in the development of shared decision-making resources.
  
  
  METHODS
  A comprehensive range of databases-MEDLINE, EMBASE, PsycINFO, AMED, Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest Nursing and Allied Health, and Web of Science-will be searched using National Library of Medicine, Medical Subject Headings (MeSH) terms as well as title, abstract, and keywords relating to different amputation levels and outcomes of interest; specifically: incidence, prevalence, and rate of amputation; rate of mortality, wound failure, dehiscence, and time between index and ipsilateral reamputations; and mobility, functional ability, activity and participation, quality of life, pain, and psychosocial outcomes including depression and anxiety. Articles that meet the inclusion criteria will be hand-searched for relevant citations. A forward citation search using Google Scholar will be used to identify articles not yet indexed. Original research published in the English language after 1 January 2000 will be included. The McMaster Critical Review Forms will be used to assess methodological quality and identify sources of bias. Included articles will be independently appraised by two reviewers. Data will be extracted using a spreadsheet based on the Cochrane Consumers and Communication Review Group's data extraction template by a primary reviewer and checked for accuracy and clarity by a second reviewer. Findings from the review will be reported as a narrative without meta-analysis given the anticipated heterogeneity of the literature.
  
  
  CONCLUSIONS
  Results from the review can be used in the design of shared decision-making resources to help inform difficult decisions about partial foot amputation.
  
  
  BACKGROUND
  PROSPERO CRD42015029186.
authors.affiliation: Discipline of Prosthetics and Orthotics, College of Science, Health and Engineering, La Trobe University, Melbourne, 3086, Australia. michael.dillon@latrobe.edu.au.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Dillon
authors.affiliation: Northwestern University Prosthetic and Orthotic Centre, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1100, Chicago, IL, 60611, USA. s-fatone@northwestern.edu.
authors.forename: Stefania
authors.initials: S
authors.lastname: Fatone
authors.affiliation: Discipline of Prosthetics and Orthotics, College of Science, Health and Engineering, La Trobe University, Melbourne, 3086, Australia. m.quigley@latrobe.edu.au.
authors.forename: Matthew
authors.initials: M
authors.lastname: Quigley
mesh_terms: D000671:Amputation, Surgical / Q000009:adverse effects* / Q000379:methods* / Q000523:psychology; D003657:Decision Making; D003661:Decision Support Techniques; D005528:Foot / Q000098:blood supply / Q000601:surgery*; D005534:Foot Diseases / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007866:Leg / Q000601:surgery*; D010358:Patient Participation; D016491:Peripheral Vascular Diseases / Q000150:complications; D011788:Quality of Life; D012086:Reoperation; D012107:Research Design; D000078202:Systematic Reviews as Topic