ReviewDiabetologia2007
Meta-analysis does not allow appraisal of complex interventions in diabetes and hypertension self-management: a methodological review.
Review in Diabetologia, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 9 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
18 citing papers in PubMed, 9 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Reduction in saturated fat intake for cardiovascular disease.The Cochrane database of systematic reviews · 2020Pooled it
- Reduction in saturated fat intake for cardiovascular disease.The Cochrane database of systematic reviews · 2020Pooled it
- Effectiveness of training in evidence-based medicine skills for healthcare professionals: a systematic review.BMC medical education · 2016Pooled it
- Team-based care and improved blood pressure control: a community guide systematic review.American journal of preventive medicine · 2014Pooled it
- Psychosocial interventions for reducing antipsychotic medication in care home residents.The Cochrane database of systematic reviews · 2012Pooled it
- Reduced or modified dietary fat for preventing cardiovascular disease.The Cochrane database of systematic reviews · 2012Pooled it
- Reduced or modified dietary fat for preventing cardiovascular disease.The Cochrane database of systematic reviews · 2011Pooled it
- Interventions for preventing and reducing the use of physical restraints in long-term geriatric care.The Cochrane database of systematic reviews · 2011Pooled it
- Reduction of diabetes risk in routine clinical practice: are physical activity and nutrition interventions feasible and are the outcomes from reference trials replicable? A systematic review and meta-analysis.BMC public health · 2010Pooled it
- An informed shared decision making programme on the prevention of myocardial infarction for patients with type 2 diabetes in primary care: protocol of a cluster randomised, controlled trial.BMC family practice · 2015Trial
- Synthesising quantitative evidence in systematic reviews of complex health interventions.BMJ global health · 2019Article
- The effect of text message support on diabetes self-management in developing countries - A randomised trial.Journal of clinical & translational endocrinology · 2017Article
- Oral health educational interventions for nursing home staff and residents.The Cochrane database of systematic reviews · 2016Review
- Technology, cognition and error.BMJ quality & safety · 2015Article
- Decision aids for patients.Deutsches Arzteblatt international · 2012Review
- Tailoring an intervention to the context and system redesign related to the intervention: a case study of implementing shared medical appointments for diabetes.Implementation science : IS · 2008Article
- Diversity in diabetes care programmes and views on high quality diabetes care: are we in need of a standardized framework?International journal of integrated care · 2008Article
- MATRIX - development and feasibility of a guide for quality assessment of patient decision aids.Psycho-social medicine · 2007Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Common methodologies used in systematic reviews do not allow adequate appraisal of complex interventions. The aim of the present study was to describe and critically appraise current methods of systematic reviews on complex interventions, using diabetes and hypertension patient education as examples. PubMed, the Cumulative Index to Nursing and Allied Health (CINAHL), the Cochrane Library and Health Technology Assessment databases were searched. Systematic reviews focusing on diabetes or hypertension patient education were included. Authors were contacted. Two investigators independently evaluated the reviews. The available evidence of three patient education programmes of diabetes and hypertension self-management implemented in Germany was used as a reference. We included 14 reviews; 12 reviews mentioned that the included education programmes were multidimensional. Reviews on comparable topics identified different publications of the same programme. Identical programmes were classified differently within and between reviews. Education programmes were dissected to analyse effects of single components. Different components of identical programmes were used. Interdependencies between components were not explored. Six reviews performed meta-analysis across programmes with heterogeneous educational or organisational approaches. The complexity of efficacy measures was disregarded: e.g. HbA(1c) was used as an isolated outcome variable without considering treatment goals, effects on hypoglycaemia, body weight or quality of life. Our results indicate that methods of current systematic reviews are not fully equipped to appraise patient education and self-management programmes. Since these are complex and heterogeneous interventions, consideration of aggregated evidence is necessary.
Indexed as
Identifiers
What OpenQuestion holds
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.