Evidence map›Paper›PMID 16095434›Full record

SynthesisThe American journal of managed care2005

A meta-analysis of interventions to improve care for chronic illnesses.

Alexander C Tsai, Sally C Morton, Carol M Mangione, Emmett B Keeler

Registry-linked trialAbstract readMeta-Analysis
PubMed Full text at PMC
In one paragraph

Synthesis in The American journal of managed care, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01319656 (Adaptation, Implementation and Evaluation of an Intervention Involving the Integration of Chronic Disease Rehabilitation Services Into Primary Care), which is not on this map. Cited by 183 papers, 20 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
183citing papers in PubMed, 20 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.

NCT01319656 nacompletednot on this mapstarted 2011, after this paper: background citation

Adaptation, Implementation and Evaluation of an Intervention Involving the Integration of Chronic Disease Rehabilitation Services Into Primary Care

TypeinterventionalSponsorMartin FortinRan2011 to 2013Enrolled326ConditionsCardiovascular Disease, Heart Failure, Chronic Obstructive Pulmonary Disease, AsthmaArmsSupport, management, educational, counselling, follow-up
3 · Its place in the literature

Who cites it

183 citing papers in PubMed, 20 syntheses or guidelines pooled it.

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  6. Interventions to improve hearing aid use in adult auditory rehabilitation.The Cochrane database of systematic reviews · 2016
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  8. Chronic disease management programmes for adults with asthma.The Cochrane database of systematic reviews · 2015
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  10. Integrated care programmes for adults with chronic conditions: a meta-review.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2014
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  14. Nurse versus physician-led care for the management of asthma.The Cochrane database of systematic reviews · 2013
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123 more citing papers are in PubMed but not listed here.

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

4 authors.

Alexander C TsaiDepartment of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, WG-57 10900 Euclid Avenue, Cleveland, OH 44106-4945, USA. act2@case.edu
Sally C Morton
Carol M Mangione
Emmett B Keeler

Funding

AHRQ Training Program Health Services ResearchT32HS000059 · AHRQ · CASE WESTERN RESERVE UNIVERSITY · PI RIMM, ALFRED · 1993 to 2012
$2.0M
Measuring Hospital Quality and Its Effects on BargainingR36HS014151 · AHRQ · CASE WESTERN RESERVE UNIVERSITY · PI TSAI, ALEXANDER C · 2004 to 2004
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AHRQ HHS HS000059-15AHRQ HHS R36 HS 014151-01AHRQ HHS T32 HS000059AHRQ HHS T32 HS 00059-06NIA NIH HHS AG 02004
6 · The paper itself

Abstract

objectiveTo use empirical data from previously published literature to address 2 research questions: (1) Do interventions that incorporate at least 1 element of the Chronic Care Model (CCM) result in improved outcomes for specific chronic illnesses? (2) Are any elements essential for improved outcomes? STUDY

designMeta-analysis.

methodsArticles were identified from narrative literature reviews and quantitative meta-analyses, each of which covered multiple bibliographic databases from inception to March 2003. We supplemented this strategy by searching the MEDLINE database (1998-2003) and by consulting experts. We included randomized and nonrandomized controlled trials of interventions that contained 1 or more elements of the CCM for asthma, congestive heart failure (CHF), depression, and diabetes. We extracted data on clinical outcomes, quality of life, and processes of care. We then used random-effects modeling to compute pooled standardized effect sizes and risk ratios.

resultsOf 1345 abstracts screened, 112 studies contributed data to the meta-analysis: asthma, 27 studies; CHF, 21 studies; depression, 33 studies; and diabetes, 31 studies. Interventions with at least 1 CCM element had consistently beneficial effects on clinical outcomes and processes of care across all conditions studied. The effects on quality of life were mixed, with only the CHF and depression studies showing benefit. Publication bias was noted for the CHF studies and a subset of the asthma studies.

conclusionsInterventions that contain at least 1 CCM element improve clinical outcomes and processes of care--and to a lesser extent, quality of life--for patients with chronic illnesses.

Indexed as

Quality of Health CareChronic DiseaseEvidence-Based MedicineHumansUnited States

Identifiers

PMID16095434
PMCPMC3244301

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.