Evidence mapPaperPMID 30517164Full record

Trial reportPloS one2018

Cluster randomised trial on the effectiveness of a computerised prompt to refer (back) patients with type 2 diabetes.

Maaike C M Ronda, Lioe-Ting Dijkhorst-Oei, Rimke C Vos, Paul Westers, Guy E H M Rutten

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Maaike C M RondaJulius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands.ORCID 0000-0002-6829-6982
Lioe-Ting Dijkhorst-OeiDepartment of Internal Medicine, Meander Medical Centre, Amersfoort, The Netherlands.
Rimke C VosJulius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands.
Paul WestersJulius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands.
Guy E H M RuttenJulius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsInformation and communications technology (ICT) could support care organisations to cope with the increasing number of patients with diabetes mellitus. We aimed to aid diabetes care providers in allocating patients to the preferred treatment setting (hospital outpatient clinic or primary care practice), by using the Electronic Medical Record (EMR).

methodsA cluster randomised controlled trial. Physicians in primary and secondary care practices of the intervention group received an advisory message in the EMR during diabetes consultations if patients were treated in the 'incorrect' setting according to national management guidelines. Primary outcome: the proportion of patients that shifted to the correct treatment setting at one year follow-up.

results47 (38 primary care and 9 internist) practices and 2778 patients were included. At baseline, 1197 (43.1%) patients were in the correct treatment setting (intervention 599; control 598). Advice most often (68.4%) regarded a consultation with the internist. After one year 12.4% of the patients in the intervention and 10.6% in the control group (p = 0.30) had shifted to the correct setting. Main reasons for not following advice were: 1. physician's preference to consider other treatment options; 2. patients' preferences.

conclusionsWe could not find evidence that using the EMR to send consultation-linked advice to physicians resulted in a shift in patients. Physicians will not follow the advice, at least partly due to patients' preferences.

Indexed as

AgedAged, 80 and overAlgorithmsDiabetes Mellitus, Type 2Electronic Health RecordsFemaleHumansMaleMiddle AgedNetherlandsOutcome Assessment, Health CareOutpatient Clinics, HospitalPatient PreferencePractice Guidelines as TopicPrimary Health CareReferral and Consultation

Identifiers

PMID30517164
PMCPMC6281259

What Socratic holds

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LicenceCC BY
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Registered trials

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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.