Evidence mapPaperPMID 37915263Full record

Trial reportJournal of diabetes2024

Comparison of medical resources and costs among patients with coronary heart disease and impaired glucose tolerance in the Acarbose Cardiovascular Evaluation trial.

Liam Mc Morrow, Frauke Becker, Ruth L Coleman, Hertzel C Gerstein, Lars Rydén, Stefan Schöder, Alastair M Gray, Jose Leal, Rury R Holman, ACE Study Group

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of diabetes, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 9% of its field
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Guideline
  2. Trial
  3. Review
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

10 authors at 4 institutions in 4 countries.

Liam Mc MorrowHealth Economics Research Centre, University of Oxford, Oxford, UK.
Frauke BeckerHealth Economics Research Centre, University of Oxford, Oxford, UK.
Ruth L ColemanDiabetes Trials Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Hertzel C GersteinDepartment of Medicine and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada.ORCID https://orcid.org/0000-0001-8072-2836
Lars RydénDepartment of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Stefan SchöderPharma Division, Bayer AG, Berlin, Germany.
Alastair M GrayHealth Economics Research Centre, University of Oxford, Oxford, UK.
Jose LealHealth Economics Research Centre, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0001-7870-6730
Rury R HolmanDiabetes Trials Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
ACE Study Group
University of Oxford · GBBayer (Germany) · DEKarolinska Institutet · SEPopulation Health Research Institute · CA

Funding

BayerNational Institute for Health and Care Research (NIHR) Biomedical Research Centre
6 · The paper itself

Abstract

backgroundThe Acarbose Cardiovascular Evaluation (ACE) trial (ISRCTN91899513) evaluated the alpha-glucosidase inhibitor acarbose, compared with placebo, in 6522 patients with coronary heart disease and impaired glucose tolerance in China and showed a reduced incidence of diabetes. We assessed the within-trial medical resource use and costs, and quality-adjusted life years (QALYs).

methodsResource use data were collected prospectively within the ACE trial. Hospitalizations, medications, and outpatient visits were valued using Chinese unit costs. Medication use was measured in drug days, with cardiovascular and diabetes drugs summed across the trial by participant. Health-related quality of life was captured using the EuroQol-5 Dimension-3 Level questionnaire. Regression analyses were used to compare resource use, costs, and QALYs, accounting for regional variation. Costs and QALYs were discounted at 3% yearly.

resultsHospitalizations were 6% higher in the acarbose arm during the trial (rate ratio 1.06, p = .009), but there were no significant differences in total inpatient days (rate ratio 1.04, p = .30). Total costs per participant, including study drug, were significantly higher for acarbose (¥ [Yuan] 56 480, £6213), compared with placebo (¥48 079, £5289; mean ratio 1.18, p < 0.001). QALYs reported by participants in the acarbose arm (3.96 QALYs) were marginally higher than in the placebo arm (3.95 QALYs), but the difference was not statistically significant (0.01 QALYs; p = .58).

conclusionsAcarbose, compared with placebo, participants cost more due to study drug costs and reported no statistically significant difference in QALYs. These higher within-trial costs could potentially be offset in future by savings from the acarbose-related lower incidence of diabetes.

Indexed as

Coronary DiseaseDiabetes Mellitus, Type 2Glucose IntoleranceAcarboseHumansHypoglycemic AgentsQuality of LifeAcarboseHypoglycemic Agentsacarbosecostsdiabetesimpaired glucose toleranceprediabetesresource use

Identifiers

PMID37915263
PMCPMC10859317
OpenAlexW4388231017

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.