Evidence map›Paper›PMID 22344504›Full record

Trial reportClinical journal of the American Society of Nephrology : CJASN2012

A cluster randomized trial of an enhanced eGFR prompt in chronic kidney disease.

Braden Manns, Marcello Tonelli, Bruce Culleton, Peter Faris, Kevin McLaughlin, Rick Chin, Katherine Gooch, Finlay A McAlister, Ken Taub, Laurel Thorlacius and 4 more

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Clinical journal of the American Society of Nephrology : CJASN, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
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  4. Chronic disease management interventions for people with chronic kidney disease in primary care: a systematic review and meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2018
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  17. Kidney Health Strategic Clinical Network: Driving positive change to optimize kidney health in Alberta.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2019
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  19. The Cost of Care for People With Chronic Kidney Disease.Canadian journal of kidney health and disease · 2019
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Braden MannsDepartment of Medicine, University of Calgary, Alberta, Canada. Braden.Manns@albertahealthservices.ca
Marcello Tonelli
Bruce Culleton
Peter Faris
Kevin McLaughlin
Rick Chin
Katherine Gooch
Finlay A McAlister
Ken Taub
Laurel Thorlacius
Richard Krause
Monica Kearns
Brenda Hemmelgarn
Alberta Kidney Disease Network

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesDespite reporting estimated GFR (eGFR), use of evidence-based interventions in CKD remains suboptimal. This study sought to determine the effect of an enhanced eGFR laboratory prompt containing specific management recommendations, compared with standard eGFR reporting in CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A cluster randomized trial of a standard or enhanced eGFR laboratory prompt was performed in 93 primary care practices in Alberta, Canada. Although all adult patients with CKD (eGFR <60 ml/min per 1.73 m(2)) were included, medication data were only available for elderly patients (aged ≥66 years). The primary outcome, the proportion of patients with diabetes or proteinuria receiving an angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB), was assessed in elderly CKD patients.

resultsThere were 5444 elderly CKD patients with diabetes or proteinuria who were eligible for primary outcome assessment, irrespective of baseline ACEi/ARB use. ACEi/ARB use in the subsequent year was 77.1% and 76.9% in the standard and enhanced prompt groups, respectively. In the subgroup of elderly patients with an eGFR <30 ml/min per 1.73 m(2), ACEi/ARB use was higher in the enhanced prompt group. Among 22,092 CKD patients, there was no difference in the likelihood of a composite clinical outcome (death, ESRD, doubling of serum creatinine, or hospitalization for myocardial infarction, heart failure, or stroke) over a median of 2.1 years.

conclusionsIn elderly patients with CKD and an indication for ACEi/ARB, an enhanced laboratory prompt did not increase use of these medications.

Indexed as

Decision Support Systems, ClinicalGlomerular Filtration RateReminder SystemsAgedAged, 80 and overAge FactorsAlbertaAngiotensin-Converting Enzyme InhibitorsAngiotensin II Type 1 Receptor BlockersBiomarkersChronic DiseaseCluster AnalysisCreatinineDiabetic NephropathiesDrug PrescriptionsGuideline AdherenceAngiotensin-Converting Enzyme InhibitorsAngiotensin II Type 1 Receptor BlockersBiomarkersCreatinine

Identifiers

PMID22344504
PMCPMC3315340

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.