Evidence map›Paper›PMID 42463198›Full record

ArticleBMJ open2026

Implementation of a learning health system for the management of non-communicable diseases in Thailand: a realist evaluation protocol.

Milena Marszalek, Nutchar Wiwatkunupakarn, Nida Buawangpong, Kawinthip Rinpon, Natasha Herber, Chris Carvalho, Borislava Mihaylova, Dorothea Nitsch, Rohini Mathur, Tracey Chantler and 3 more

Registry-linked trialAbstract read
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06873243 (Developing a Learning Health System to Address the Growing Burden of Noncommunicable Diseases in Thailand), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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.

NCT06873243 naactive not recruitingnot on this map

Developing a Learning Health System to Address the Growing Burden of Noncommunicable Diseases in Thailand

TypeinterventionalSponsorQueen Mary University of LondonRan2024 to 2028Enrolled419ConditionsHypertension, Diabetes, Kidney Disease, Primary CareArmsLearning Health System Approach
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

13 authors.

Milena MarszalekWolfson Institute of Population Health, Queen Mary University of London, London, UK.ORCID http://orcid.org/0000-0001-5825-0609
Nutchar WiwatkunupakarnDepartment of Family Medicine, Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand.
Nida BuawangpongDepartment of Family Medicine, Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand.
Kawinthip RinponDepartment of Family Medicine, Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand.
Natasha HerberDepartment of Family Medicine, Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand.
Chris CarvalhoWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Borislava MihaylovaWolfson Institute of Population Health, Queen Mary University of London, London, UK.ORCID http://orcid.org/0000-0002-0951-1304
Dorothea NitschLondon School of Hygiene & Tropical Medicine, London, UK.
Rohini MathurWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Tracey ChantlerLondon School of Hygiene & Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0001-7776-7339
Chaisiri AngkurawaranonDepartment of Family Medicine, Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand.ORCID http://orcid.org/0000-0003-4206-9164
Wichuda JiraporncharoenDepartment of Family Medicine, Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand wichuda.j@cmu.ac.th.
John Alexander FordWolfson Institute of Population Health, Queen Mary University of London, London, UK.ORCID http://orcid.org/0000-0001-8033-7081

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLearning health systems (LHS) are an approach to translate patient data into actionable clinical insights, empower healthcare teams to drive quality improvement and reduce health inequalities. Here we present a protocol for a realist evaluation to explore what works to implement a learning health system approach in primary care settings in Thailand, for whom does it work, how, why and in what circumstances. METHODS AND ANALYSIS: A mixed-methods realist evaluation will run in parallel with an interventional trial [Reg No: NCT06873243] in Northern Thailand which aims to improve the management of hypertension (HTN), type 2 diabetes mellitus (T2DM) and chronic kidney diseases (CKDs) using a data-supported learning health systems approach. As part of the trial, 16 primary care units (PCUs) in Chiang Mai and Lamphun provinces will be randomly selected to receive a learning health system intervention to support quality improvement for care of HTN, T2DM and CKD. Performance will be compared between intervention PCUs and all other PCUs in the region. Participants of the realist evaluation will include clinical and other professional staff involved in the development and implementation of the LHS. This realist evaluation will use both quantitative and qualitative data, including semi-structured interviews, surveys and documents from participating sites. Quantitative and qualitative findings will be systematically integrated to test, refine and validate context-mechanism-outcomes to identify consistencies, contradictions and explanatory mechanisms as part of a final programme theory for the successful implementation of the LHS. ETHICS AND DISSEMINATION: Ethical approval has been granted by all collaborating university Research Ethics Committees (ref: 1090, 0321, 32540). Results will be disseminated to stakeholders, including patients and the public, health providers, the Thai government and WHO office. Our methods and dissemination will be guided by National Institute for Health Research and Guidelines International Network reporting standards for Patient and Public Involvement and Engagement.

Indexed as

Diabetes Mellitus, Type 2HypertensionLearning Health SystemNoncommunicable DiseasesPrimary Health CareQuality ImprovementRenal Insufficiency, ChronicHumansResearch DesignThailandDiabetes Mellitus, Type 2Digital TechnologyHypertensionQuality Improvement

Identifiers

PMID42463198
PMCPMC13384129

What Socratic holds

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LicenceCC BY
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Registered trials

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.