How we appraise
Every source is read in full where the full text can be obtained legally, critically appraised with the instrument its design calls for, and filed under each topic it bears on. Sources that do not support a treatment are kept and shown: an evidence library is most useful where it says what the evidence does not show. The method is the same as the NPWT Evidence Library's.
Where the sources come from
The maintainer's reference library (lymphoedema and lipoedema collections, and lymphoedema items filed elsewhere); a publication list supplied by a South African lymphoedema therapist and researcher; legal open-access copies (the Lymphology open archive, Unpaywall, PubMed Central open-access text, SciELO South Africa); and papers retrieved by the maintainer. Paywalls and publisher bot checks are never bypassed. A duplicate check on DOI, PMID and title runs before any source is added.
| Study type | Sources |
|---|---|
| Systematic review | 86 |
| Randomised trial | 75 |
| Primary study | 36 |
| Narrative review | 35 |
| Guideline or consensus | 21 |
| Textbook | 18 |
| Case report | 13 |
| Patient information | 5 |
| Diagnostic or measurement study | 4 |
| Cohort study | 3 |
| Magazine article | 3 |
| Conference item | 3 |
| Book chapter | 1 |
| Manufacturer material | 1 |
| Advertisement | 1 |
| South African guidance | 1 |
| Flagged document | 1 |
| News item | 1 |
Ratings
| Rating | Question it answers | Scale |
|---|---|---|
| GRADE ⊕⊕⊕◯ Moderate | Evidence certainty. How sure can we be of this source's main finding? | GRADE: High ⊕⊕⊕⊕, Moderate ⊕⊕⊕◯, Low ⊕⊕◯◯, Very low ⊕◯◯◯. The card shows the certainty of the source's first-listed (main) finding; every finding and the reason for each downgrade are under "Appraisal and reference". Where GRADE does not apply (opinion, case reports, patient information), the OCEBM level of evidence is shown instead. |
| Guideline quality 3/7 | Guideline quality. How well was this guideline or consensus developed? | AGREE II overall score out of 7, from this library's own appraisal, with the six domain scores in the appraisal. |
Other labels on a card
| Study type | The design: randomised trial, systematic review, cohort, guideline, case report, and so on. Manufacturer material, advertisements and patient leaflets are labelled as such and ranked lowest. |
| Direction | Set by one mechanical rule: the pre-specified primary outcome decides. Positive primary outcome: the treatment or test studied was significantly better than its comparator. Null or negative primary outcome: no significant difference, or harm. Context: no comparison (guidelines, reviews without pooled effects, case reports, measurement studies, opinion), a superseded interim report, or a risk-factor analysis. |
| Figures | Figures checked: every number on the card was compared with the paper's tables and recalculated where a claim depends on it. Citation only: the full text could not be obtained; the source is listed but not appraised. These checks, like the appraisals, are carried out by Anthropic's Claude; they are not independent double extraction. |
| Reviewed | The date the appraisal was last reviewed. |
Instruments
RoB 2 for randomised trials; AMSTAR 2 for systematic reviews; AGREE II for guidelines and consensus documents; QUADAS-2 for diagnostic accuracy; Newcastle–Ottawa or ROBINS-I for cohorts; JBI checklists for case reports, case series and text-and-opinion documents. GRADE certainty is given per outcome with a written reason for each downgrade. Funding, conflicts of interest, retraction status and internal errors are recorded for every source.
Changes
- 9 October 2026. Library published. All 308 sources were re-appraised to the NPWT library standard on 8–9 October 2026; positions that changed on re-appraisal are marked "revised" with the date on the topic pages.
About this library
Maintained by Dr Gregory Weir, vascular surgeon, Pretoria. Who decides what: Dr Weir adds sources to the library. The appraisals, figure checks, direction labels and certainty ratings are made by Anthropic's Claude under the rules on this page.
Funding and conflicts of interest: Dr Gregory Weir is a vascular surgeon in independent private practice who encourages optimal conservative management of lymphoedema. His practice refers patients to lymphoedema therapists and has no direct financial interest in the treatment or surgery of these patients. The practice facilitates the clinical assessment and diagnosis of patients with appropriate referral. The practice has no support from industry.
Privacy
The library collects no personal information through its pages. The site counts visits with Google Analytics, which processes technical data such as IP address and browser type and sets cookies. Privacy notice. Nothing a visitor types into a search or filter is sent anywhere: filtering runs in the browser.
Product names are trademarks of their owners and are used only to identify the products studied. This library has no connection with any manufacturer.
Corrections and suggestions are welcome: please email [email protected].