Evidence map›Paper›PMID 23129571›Full record

ArticleBMJ open2012

Clinical effectiveness of a patient decision aid to improve decision quality and glycaemic control in people with diabetes making treatment choices: a cluster randomised controlled trial (PANDAs) in general practice.

Nigel Mathers, Chirk Jenn Ng, Michael Joseph Campbell, Brigitte Colwell, Ian Brown, Alastair Bradley

2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 50 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 14 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.

NCT04995796 nacompletednot on this mapstarted 2021, after this paper: background citation

Testing the Decision Aid: Supporting Patient Decisions About Upper Extremity Surgery in Cervical Spinal Cord Injury (AIM 3)

TypeinterventionalSponsorWashington University School of MedicineRan2021 to 2022Enrolled40ConditionsCervical Spinal Cord Injury, TetraplegiaArmsSurveys for Research Purposes
NCT06410768 naunknown statusnot on this mapstarted 2024, after this paper: background citation

Evaluating the Feasibility of a Future Trial-based Economic Evaluation of a Multistage Shared Decision-making Program for the Treatment of Type 2 Diabetes Mellitus: a Pilot Study

TypeinterventionalSponsorMaastricht University Medical CenterRan2024 to 2025Enrolled40ConditionsDiabetes Mellitus, Type 2Armsmultistage shared decision-making program
3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 14 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2017
    Pooled it
  13. Pooled it
  14. Pooled it
  15. Trial
  16. Trial
  17. Trial
  18. Impact and Feasibility of Personalized Decision Support for Older Patients with Diabetes: A Pilot Randomized Trial.Medical decision making : an international journal of the Society for Medical Decision Making · 2017
    Trial
  19. Trial
  20. Trial
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

6 authors.

Nigel MathersAcademic Unit of Primary Medical Care, Northern General Hospital, University of Sheffield, Sheffield, UK.
Chirk Jenn Ng
Michael Joseph Campbell
Brigitte Colwell
Ian Brown
Alastair Bradley

Funding

Department of Health IAT/I-PF/010/003
6 · The paper itself

Abstract

objectiveTo determine the effectiveness of a patient decision aid (PDA) to improve decision quality and glycaemic control in people with diabetes making treatment choices using a cluster randomised controlled trial (RCT).

designA cluster RCT.

setting49 general practices in UK randomised into intervention (n=25) and control (n=24).

participantsGeneral practices Inclusion criteria: >4 medical partners; list size >7000; and a diabetes register with >1% of practice population. 191 practices assessed for eligibility, and 49 practices randomised and completed the study. Patients People with type 2 diabetes mellitus (T2DM) taking at least two oral glucose-lowering drugs with maximum tolerated dose with a glycosolated haemoglobin (HbA1c) greater than 7.4% (IFCC HbA1c >57 mmol/mol) or advised in the preceeding 6 months to add or consider changing to insulin therapy. EXCLUSION CRITERIA: currently using insulin therapy; difficulty reading or understanding English; difficulty in understanding the purpose of the study; visual or cognitive impairment or mentally ill. A total of 182 assessed for eligibility, 175 randomised to 95 intervention and 80 controls, and 167 completion and anlaysis.

interventionBrief training of clinicians and use of PDA with patients in single consultation. PRIMARY OUTCOMES: Decision quality (Decisional Conflict Scores, knowledge, realistic expectations and autonomy) and glycaemic control (glycosolated haemoglobin, HbA1c). SECONDARY OUTCOMES: Knowledge and realistic expectations of the risks and benefits of insulin therapy and diabetic complications.

resultsIntervention group: lower total Decisional Conflict Scores (17.4 vs 25.2, p<0.001); better knowledge (51.6% vs 28.8%, p<0.001); realistic expectations (risk of 'hypo', 'weight gain', 'complications'; 81.0% vs 5.2%, 70.5% vs 5.3%, 26.3% vs 5.0% respectively, p<0.001); and were more autonomous in decision-making (64.1% vs 42.9%, p=0.012). No significant difference in the glycaemic control between the two groups.

conclusionsUse of the PANDAs decision aid reduces decisional conflict, improves knowledge, promotes realistic expectations and autonomy in people with diabetes making treatment choices in general practice. ISRCTN TRIALS REGISTER NUMBER: 14842077.

Identifiers

PMID23129571
PMCPMC3532975

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.