Evidence map›Paper›PMID 23536132›Full record

Trial reportKidney international2013

Audit-based education lowers systolic blood pressure in chronic kidney disease: the Quality Improvement in CKD (QICKD) trial results.

Simon de Lusignan, Simon de Lusignana, Hugh Gallagher, Simon Jones, Tom Chan, Jeremy van Vlymen, Aumran Tahir, Nicola Thomas, Neerja Jain, Olga Dmitrieva and 3 more

Erratum issuedAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Kidney international, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 42 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 5 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Guideline
  3. Guideline
  4. Chronic disease management interventions for people with chronic kidney disease in primary care: a systematic review and meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2018
    Pooled it
  5. Pooled it
  6. Trial
  7. Trial
  8. Trial
  9. Effect of shared care on blood pressure in patients with chronic kidney disease: a cluster randomised controlled trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2013
    Trial
  10. Trial
  11. Trial
  12. Article
  13. Article
  14. Inequities in kidney health and kidney care.Nature reviews. Nephrology · 2023
    Review
  15. Article
  16. Uncoded chronic kidney disease in primary care: a cross-sectional study of inequalities and cardiovascular disease risk management.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020
    Article
  17. Article
  18. Article
  19. Improving coding and primary care management for patients with chronic kidney disease: an observational controlled study in East London.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019
    Observational
  20. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Simon de Lusignan
Simon de LusignanaDepartment of Health Care Management and Policy, University of Surrey, Guildford, UK. s.lusignan@surrey.ac.uk
Hugh Gallagher
Simon Jones
Tom Chan
Jeremy van Vlymen
Aumran Tahir
Nicola Thomas
Neerja Jain
Olga Dmitrieva
Imran Rafi
Andrew McGovern
Kevin Harris

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Strict control of systolic blood pressure is known to slow progression of chronic kidney disease (CKD). Here we compared audit-based education (ABE) to guidelines and prompts or usual practice in lowering systolic blood pressure in people with CKD. This 2-year cluster randomized trial included 93 volunteer general practices randomized into three arms with 30 ABE practices, 32 with guidelines and prompts, and 31 usual practices. An intervention effect on the primary outcome, systolic blood pressure, was calculated using a multilevel model to predict changes after the intervention. The prevalence of CKD was 7.29% (41,183 of 565,016 patients) with all cardiovascular comorbidities more common in those with CKD. Our models showed that the systolic blood pressure was significantly lowered by 2.41 mm Hg (CI 0.59-4.29 mm Hg), in the ABE practices with an odds ratio of achieving at least a 5 mm Hg reduction in systolic blood pressure of 1.24 (CI 1.05-1.45). Practices exposed to guidelines and prompts produced no significant change compared to usual practice. Male gender, ABE, ischemic heart disease, and congestive heart failure were independently associated with a greater lowering of systolic blood pressure but the converse applied to hypertension and age over 75 years. There were no reports of harm. Thus, individuals receiving ABE are more likely to achieve a lower blood pressure than those receiving only usual practice. The findings should be interpreted with caution due to the wide confidence intervals.

Indexed as

AdultAgedBlood PressureComorbidityDisease ManagementFemaleGeneral PracticeHumansHypertensionMaleMedical AuditMiddle AgedOutcome Assessment, Health CarePractice Guidelines as TopicPractice Patterns, Physicians'Quality Improvement

Identifiers

PMID23536132
PMCPMC3778715

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.