Evidence map›Paper›PMID 22692651›Full record

Trial reportBMJ (Clinical research ed.)2012

Internet based vascular risk factor management for patients with clinically manifest vascular disease: randomised controlled trial.

J W P Vernooij, H A H Kaasjager, Y van der Graaf, J Wierdsma, H M H Grandjean, M M C Hovens, G A de Wit, F L J Visseren, SMARTStudy Group

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00785031 (Internet-based Vascular Risk Factor Management for Patients With Clinical Manifest Vascular Disease; a Randomized Controlled Trial), which is not on this map. Cited by 40 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 11 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.

NCT00785031 nacompletednot on this map

Internet-based Vascular Risk Factor Management for Patients With Clinical Manifest Vascular Disease; a Randomized Controlled Trial

TypeinterventionalSponsorUMC UtrechtRan2008 to 2011Enrolled330ConditionsCardiovascular DiseasesArmsinternet based vascular risk factor intervention
3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  15. Case management for blood pressure and lipid level control after minor stroke: PREVENTION randomized controlled trial.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2014
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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

9 authors.

J W P VernooijDepartment of Vascular Medicine, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, Netherlands.
H A H Kaasjager
Y van der Graaf
J Wierdsma
H M H Grandjean
M M C Hovens
G A de Wit
F L J Visseren
SMARTStudy Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate whether an internet based, nurse led vascular risk factor management programme promoting self management on top of usual care is more effective than usual care alone in reducing vascular risk factors in patients with clinically manifest vascular disease.

designProspective randomised controlled trial.

settingMulticentre trial in secondary and tertiary healthcare setting.

participants330 patients with a recent clinical manifestation of atherosclerosis in the coronary, cerebral, or peripheral arteries and with at least two treatable risk factors not at goal.

interventionPersonalised website with an overview and actual status of patients' risk factors and mail communication via the website with a nurse practitioner for 12 months; the intervention combined self management support, monitoring of disease control, and drug treatment.

main outcome measuresThe primary endpoint was the relative change in Framingham heart risk score after 1 year. Secondary endpoints were absolute changes in the levels of risk factors and the differences between groups in the change in proportion of patients reaching treatment goals for each risk factor.

resultsParticipants' mean age was 59.9 (SD 8.4) years, and most patients (n=246; 75%) were male. After 1 year, the relative change in Framingham heart risk score of the intervention group compared with the usual care group was -14% (95% confidence interval -25% to -2%). At baseline, the Framingham heart risk score was higher in the intervention group than in the usual care group (16.1 (SD 10.6) v 14.0 (10.5)), so the outcome was adjusted for the separate variables of the Framingham heart risk score and for the baseline Framingham heart risk score. This produced a relative change of -12% (-22% to -3%) in Framingham heart risk score for the intervention group compared with the usual care group adjusted for the separate variables of the score and -8% (-18% to 2%) adjusted for the baseline score. Of the individual risk factors, a difference between groups was observed in low density lipoprotein cholesterol (-0.3, -0.5 to -0.1, mmol/L) and smoking (-7.7%, -14.9% to -0.4%). Some other risk factors tended to improve (body mass index, triglycerides, systolic blood pressure, renal function) or tended to worsen (glucose concentration, albuminuria).

conclusionAn internet based, nurse led treatment programme on top of usual care for vascular risk factors had a small effect on lowering vascular risk and on lowering of some vascular risk factors in patients with vascular disease.

trial registrationClinical trials NCT00785031.

Indexed as

InternetAtherosclerosisCerebrovascular DisordersCoronary Artery DiseaseFemaleHeart DiseasesHemorrhageHumansKaplan-Meier EstimateMaleMiddle AgedPeripheral Vascular DiseasesPilot ProjectsProspective StudiesRisk FactorsRisk Management

Identifiers

PMID22692651
PMCPMC3374126

What OpenQuestion holds

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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.