Evidence map›Paper›PMID 19933961›Full record

Trial reportArchives of internal medicine2009

Case management to reduce risk of cardiovascular disease in a county health care system.

Jun Ma, Kathy Berra, William L Haskell, Linda Klieman, Shauna Hyde, Mark W Smith, Lan Xiao, Randall S Stafford

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Archives of internal medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00128687 (Improving Coronary Prevention in a County Health System), which is not on this map. Cited by 33 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 9 pooled it
6.5field-weighted citation impact, top 4% 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.

NCT00128687 nacompletednot on this map

Improving Coronary Prevention in a County Health System

TypeinterventionalSponsorStanford UniversityRan2003 to 2008Enrolled419ConditionsCardiovascular Diseases, Coronary Disease, Risk Reduction, Heart DiseasesArmsrisk reduction
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 9 syntheses or guidelines pooled it, 69 citations in OpenAlex.

  1. Clinical service organisation for adults with atrial fibrillation.The Cochrane database of systematic reviews · 2024
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  6. Risk scoring for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2017
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Jun MaPalo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.
Kathy Berra
William L Haskell
Linda Klieman
Shauna Hyde
Mark W Smith
Lan Xiao
Randall S Stafford
Palo Alto Institute · US

Funding

Improving Coronary Prevention in a County Health SystemR01HL070781 · NHLBI · STANFORD UNIVERSITY · PI STAFFORD, RANDALL SCOTT · 2003 to 2007
$3.6M
Translating Clinical Decision Making into Systems of Care: A Mid-Career MentorK24HL086703 · NHLBI · STANFORD UNIVERSITY · PI STAFFORD, RANDALL SCOTT · 2007 to 2016
$1.5M
NHLBI NIH HHS K24 HL086703NHLBI NIH HHS R01 HL070781
6 · The paper itself

Abstract

backgroundCase management (CM) is a systematic approach to supplement physician-centered efforts to prevent cardiovascular disease (CVD). Research is limited on its implementation and efficacy in low-income, ethnic minority populations.

methodsWe conducted a randomized clinical trial to evaluate a nurse- and dietitian-led CM program for reducing major CVD risk factors in low-income, primarily ethnic minority patients in a county health care system, 63.0% of whom had type 2 diabetes mellitus. The primary outcome was the Framingham risk score (FRS).

resultsA total of 419 patients at elevated risk of CVD events were randomized and followed up for a mean of 16 months (81.4% retention). The mean FRS was significantly lower for the CM vs usual care group at follow-up (7.80 [95% confidence interval, 7.21-8.38] vs 8.93 [8.36-9.49]; P = .001) after adjusting for baseline FRS. This is equivalent to 5 fewer heart disease events per 1000 individuals per year attributable to the intervention or to 200 individuals receiving the intervention to prevent 1 event per year. The pattern of group differences in the FRS was similar in subgroups defined a priori by sex and ethnicity. The main driver of these differences was lowering the mean (SD) systolic (-4.2 [18.5] vs 2.6 [22.7] mm Hg; P = .003) and diastolic (-6.0 [11.6] vs -3.0 [11.7] mm Hg; P = .02) blood pressures for the CM vs usual care group.

conclusionNurse and dietitian CM targeting multifactor risk reduction can lead to modest improvements in CVD risk factors among high-risk patients in low-income, ethnic minority populations receiving care in county health clinics.

trial registrationclinicaltrials.gov Identifier: NCT00128687.

Indexed as

Cardiovascular DiseasesCase ManagementHealth BehaviorPreventive Health ServicesRisk Reduction BehaviorAdultAgedBody WeightCaliforniaCounselingDietFemaleHumansIncomeMaleMiddle Aged

Identifiers

PMID19933961
PMCPMC3000904
OpenAlexW2045104434

What OpenQuestion holds

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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.