***TASK***
the task is to simplify the input abstract of a biomedical literature

***INPUT***
the input is the abstract of a biomedical literature

***OUTPUT***
the output is the simplified abstract for the input abstract of a biomedical literature

***DOCUMENTATION***

***EXAMPLES***

Input: Only six RCTs met the criteria for inclusion. The study characteristics differed substantially in terms of healthcare settings, the nature of the interventions studied and outcome measures reported. In three studies that compared the effect of an education-centred complex intervention with usual care or written instructions, only little evidence of benefit was found. Three studies compared the effect of more intensive and comprehensive complex interventions with usual care. One study found a significant and cost-effective reduction, one of lower extremity amputations (RR 0.30, 95% CI 0.31 to 0.71). One other study found a significant reduction of both amputation and foot ulcers. The last study reported improvement of patients' self care behaviour. All six included RCTs were at high risk of bias, with hardly any of the predefined quality assessment criteria met. There is no high-quality research evidence evaluating complex interventions for preventing diabetic foot ulceration and insufficient evidence of benefit.
Output:

Foot ulcers not only lead to physical disability and loss of quality of life, but also to economic burden (healthcare costs, industrial disability). The aim is therefore to prevent foot ulcers occurring, for example, by showing patients with diabetes how to look after their feet or by prompting doctors to check their patients' feet more often. The results of single prevention strategies alone have so far been disappointing, therefore in clinical practice, preventive interventions directed at patients, healthcare providers and/or the structure of health care are often combined. In this review of trials of complex, preventive interventions, we found insufficient evidence that these combined approaches can be effective in reducing foot problems.