Trial reportQuality & safety in health care2003
Intensive support to improve clinical decision making in cardiovascular care: a randomised controlled trial in general practice.
Trial report in Quality & safety in health care, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 11 of them syntheses that pooled 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.
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.
Who cites it
23 citing papers in PubMed, 11 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Effectiveness of quality improvement interventions in improving cardiovascular disease-related outcomes in primary and tertiary care: A systematic review and meta-analyses.BMC primary care · 2025Pooled it
- Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025Pooled it
- Exploring the content and delivery of feedback facilitation co-interventions: a systematic review.Implementation science : IS · 2024Pooled it
- Decision coaching for people making healthcare decisions.The Cochrane database of systematic reviews · 2021Pooled it
- Pooled it
- Pooled it
- Audit and feedback: effects on professional practice and healthcare outcomes.The Cochrane database of systematic reviews · 2012Pooled it
- The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs.The Canadian journal of cardiology · 2010Guideline
- Does the routine use of global coronary heart disease risk scores translate into clinical benefits or harms? A systematic review of the literature.BMC health services research · 2008Pooled it
- Educational outreach visits: effects on professional practice and health care outcomes.The Cochrane database of systematic reviews · 2007Pooled it
- Systematic review and meta-analysis of practice facilitation within primary care settings.Annals of family medicinePooled it
- Point-of-care tools to support optometric care provision to people with age-related macular degeneration: A randomised, placebo-controlled trial.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2022Trial
- Trial
- A real-world stepped wedge cluster randomized trial of practice facilitation to improve cardiovascular care.Implementation science : IS · 2015Trial
- Effectiveness of improvement plans in primary care practice accreditation: a clustered randomized trial.PloS one · 2014Trial
- Improved delivery of cardiovascular care (IDOCC) through outreach facilitation: study protocol and implementation details of a cluster randomized controlled trial in primary care.Implementation science : IS · 2011Trial
- The @RISK Study: Risk communication for patients with type 2 diabetes: design of a randomised controlled trial.BMC public health · 2010Trial
- Multifaceted support to improve preventive cardiovascular care: a nationwide, controlled trial in general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2003Trial
- Toward Standardized Monitoring of Patients With Chronic Diseases in Primary Care Using Electronic Medical Records: Systematic Review.JMIR medical informatics · 2019Review
- Characteristics of Academic Detailing: Results of a Literature Review.American health & drug benefits · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the effects of feedback reports combined with outreach visits from trained non-physicians on the clinical decision making of general practitioners (GPs) in cardiovascular care.
designPragmatic cluster controlled trial with randomisation of practices to support (intervention group) or no special attention (control group); analysis after 2 years.
setting124 general practices in The Netherlands.
participants185 GPs.
main outcome measuresCompliance rates for 12 evidence-based indicators for the management of patients with hypertension, hypercholesterolaemia, angina pectoris, or heart failure. The evaluation relied on the prospective recording of patient encounters by the participating GPs.
resultsThe GPs reported 30 101 clinical decisions at baseline and 22 454 decisions after the intervention. A significant improvement was seen for five of the 12 indicators: assessment of risk factors in patients with hypercholesterolaemia (odds ratio 2.04; 95% CI 1.44 to 2.88) or angina pectoris (3.07; 1.08 to 8.79), provision of information and advice to patients with hypercholesterolaemia (1.58, 1.17 to 2.13) or hypertension (1.55, 1.35 to 1.77), and checking for clinical signs of deterioration in patients with heart failure (4.11, 2.17 to 7.77). Single handed practices, non-training practices, and practices with older GPs gained particular benefit from the intervention.
conclusionsIntensive support from trained non-physicians can alter certain aspects of the clinical decision making of GPs in cardiovascular care. The effect is small and the strategy needs further development.
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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 OpenQuestion graph.