Evidence map›Paper›PMID 25559011›Full record

Trial reportJournal of the American Heart Association2015

Evaluation of effectiveness and cost-effectiveness of a clinical decision support system in managing hypertension in resource constrained primary health care settings: results from a cluster randomized trial.

Raghupathy Anchala, Stephen Kaptoge, Hira Pant, Emanuele Di Angelantonio, Oscar H Franco, D Prabhakaran

Registry-linked trialOpen access · goldAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Heart Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06258473 (Addressing Gaps in the Hypertension and Diabetes Care Continuum in Rural Bangladesh Through mHealth and Decentralized Primary Care), which is not on this map. Cited by 52 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 9 pooled it
6.2field-weighted citation impact, top 3% 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.

NCT06258473 phase1recruitingnot on this mapstarted 2024, after this paper: background citation

Addressing Gaps in the Hypertension and Diabetes Care Continuum in Rural Bangladesh Through mHealth and Decentralized Primary Care: The Dinajpur Study

TypeinterventionalSponsorBRAC UniversityRan2024 to 2026Enrolled6,750ConditionsHypertension, DiabetesArmsMulticomponent decentralized care, mHealth
3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 9 syntheses or guidelines pooled it, 95 citations in OpenAlex.

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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

6 authors at 3 institutions in 3 countries.

Raghupathy AnchalaPublic Health Foundation of India - Indian Institute of Public Health, Hyderabad, India (R.A., H.P.) Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (R.A., S.K., E.D.A.).
Stephen KaptogeCardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (R.A., S.K., E.D.A.).
Hira PantPublic Health Foundation of India - Indian Institute of Public Health, Hyderabad, India (R.A., H.P.).
Emanuele Di AngelantonioCardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (R.A., S.K., E.D.A.).
Oscar H FrancoDepartment of Epidemiology, Erasmus MC, Rotterdam, The Netherlands (O.H.F.).
D PrabhakaranPublic Health Foundation of India, New Delhi, India (P.) Center for Chronic Disease Control, New Delhi, India (P.).
Public Health Foundation of India · INUniversity of Cambridge · GBErasmus University Rotterdam · NL

Funding

British Heart Foundation RG/08/014/24067Medical Research Council MR/L003120/1Wellcome Trust 084754
6 · The paper itself

Abstract

backgroundRandomized control trials from the developed world report that clinical decision support systems (DSS) could provide an effective means to improve the management of hypertension (HTN). However, evidence from developing countries in this regard is rather limited, and there is a need to assess the impact of a clinical DSS on managing HTN in primary health care center (PHC) settings. METHODS AND

resultsWe performed a cluster randomized trial to test the effectiveness and cost-effectiveness of a clinical DSS among Indian adult hypertensive patients (between 35 and 64 years of age), wherein 16 PHC clusters from a district of Telangana state, India, were randomized to receive either a DSS or a chart-based support (CBS) system. Each intervention arm had 8 PHC clusters, with a mean of 102 hypertensive patients per cluster (n=845 in DSS and 783 in CBS groups). Mean change in systolic blood pressure (SBP) from baseline to 12 months was the primary endpoint. The mean difference in SBP change from baseline between the DSS and CBS at the 12th month of follow-up, adjusted for age, sex, height, waist, body mass index, alcohol consumption, vegetable intake, pickle intake, and baseline differences in blood pressure, was -6.59 mm Hg (95% confidence interval: -12.18 to -1.42; P=0.021). The cost-effective ratio for CBS and DSS groups was $96.01 and $36.57 per mm of SBP reduction, respectively.

conclusionClinical DSS are effective and cost-effective in the management of HTN in resource-constrained PHC settings. CLINICAL TRIAL REGISTRATION URL: http://www.ctri.nic.in. Unique identifier: CTRI/2012/03/002476.

Indexed as

AdultClinical Decision-MakingCluster AnalysisCost-Benefit AnalysisDecision Support Systems, ClinicalFemaleHealth ResourcesHumansHypertensionIndiaMaleMiddle AgedPrimary Health Carecluster randomized trialscomputerscost‐effectivenesseffectivenesshypertension

Identifiers

PMID25559011
PMCPMC4330052
OpenAlexW2168061372

What OpenQuestion holds

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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.