Evidence map›Paper›PMID 24030517›Full record

Trial reportInternational journal of obesity (2005)2014

The challenge of a 2-year follow-up after intervention for weight loss in primary care.

C Holzapfel, L Cresswell, A L Ahern, N R Fuller, M Eberhard, J Stoll, A P Mander, S A Jebb, I D Caterson, H Hauner

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of obesity (2005), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 2 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

20 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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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

10 authors.

C HolzapfelElse Kroener-Fresenius-Centre for Nutritional Medicine, Technische Universität München, University Hospital 'Klinikum rechts der Isar', Munich, Germany.
L CresswellMRC Biostatistics Unit, Cambridge, UK.
A L AhernMRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.
N R FullerBoden Institute, Medical Foundation Building K25, University of Sydney, Sydney, NSW, Australia.
M EberhardMRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.
J StollElse Kroener-Fresenius-Centre for Nutritional Medicine, Technische Universität München, University Hospital 'Klinikum rechts der Isar', Munich, Germany.
A P ManderMRC Biostatistics Unit, Cambridge, UK.
S A JebbMRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.
I D CatersonBoden Institute, Medical Foundation Building K25, University of Sydney, Sydney, NSW, Australia.
H HaunerElse Kroener-Fresenius-Centre for Nutritional Medicine, Technische Universität München, University Hospital 'Klinikum rechts der Isar', Munich, Germany.

Funding

Medical Research Council MC_U105960389Medical Research Council MC_UP_1302/2
6 · The paper itself

Abstract

backgroundMany weight loss programmes show short-term success, but long-term data in larger studies are scarce, especially in community settings. Attrition is common and complicates the interpretation of long-term outcomes.

objectiveTo investigate 2-year outcomes and explore issues of attrition and missing data. SUBJECTS: A total of 772 overweight and obese adults recruited by primary care practices in Australia, Germany and the UK and randomised to a 12-month weight loss intervention delivered in a commercial programme (CP) or in standard care (SC). MEASUREMENT: Weight change from 0-24 and 12-24 months including measured weights only and measured and self-reported weights, using last observation carried forward (LOCF), baseline observation carried forward (BOCF), completers-only and missing-at-random (MAR) analyses.

resultsA total of 203 participants completed the 24-month visit. Using measured weights only, there was a trend for greater 24-month weight loss in CP than in SC, but the difference was only statistically significant in the LOCF and BOCF analyses: LOCF: -4.14 vs -1.99 kg, difference adjusted for centre -2.08 kg, P<0.001; BOCF: -1.33 vs -0.74 kg, adjusted difference -0.60 kg, P=0.032; completers: -4.76 vs -2.99 kg, adjusted difference -1.53 kg, P=0.113; missing at random: -3.00 vs -1.94 kg, adjusted difference -1.04 kg, P=0.150. Both groups gained weight from 12-24 months and weight regain was significantly (P<0.001) greater for CP than for SC in all analysis approaches. Inclusion of self-reported weights from a further 138 participants did not change the interpretation of the findings.

conclusionInitial weight loss was poorly maintained during the no-intervention follow-up, but both groups did have lower weight over the 24 months. Attrition was high in both groups, and assumptions about missing data had considerable impact on the magnitude and statistical significance of treatment effects. It is vital that trials on weight loss interventions consider the plausibility of these differences in an analytical approach when interpreting research findings and comparing data between studies.

Indexed as

Primary Health CareWeight GainWeight LossWeight Reduction ProgramsAdultAustraliaData CollectionFemaleFollow-Up StudiesGermanyHumansLost to Follow-UpMaleMiddle AgedObesityPatient Compliance

Identifiers

PMID24030517
PMCPMC4052429

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.