Evidence map›Paper›PMID 25873144›Full record

Trial reportTrials2015

Study protocol for a randomised controlled trial of insulin delivery by continuous subcutaneous infusion compared to multiple daily injections.

Jo Blair, John W Gregory, Dyfrig Hughes, Colin H Ridyard, Carrol Gamble, Andrew McKay, Mohammed Didi, Keith Thornborough, Emma Bedson, Lola Awoyale and 2 more

Open access · goldAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 20% 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.

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

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Article
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

12 authors at 3 institutions in 1 country.

Jo BlairDepartment of Endocrinology, Alder Hey Children's NHS Foundation Trust, Liverpool, L12 2AP, UK. jo.blair@alderhey.nhs.uk.
John W GregoryDepartment of Child Health, School of Medicine, Cardiff University, Cardiff, CF14 4XN, Wales, UK. GregoryJW@cardiff.ac.uk.
Dyfrig HughesCentre for Health Economics and Medicines Evaluation, Bangor University, Bangor, LL57 2PZ, UK. d.a.hughes@bangor.ac.uk.
Colin H RidyardCentre for Health Economics and Medicines Evaluation, Bangor University, Bangor, LL57 2PZ, UK. c.h.ridyard@bangor.ac.uk.
Carrol GambleLiverpool Clinical Trials Research Centre, Liverpool, L12 2AP, UK. C.Gamble@liverpool.ac.uk.
Andrew McKayLiverpool Clinical Trials Research Centre, Liverpool, L12 2AP, UK. A.Mckay@liverpool.ac.uk.
Mohammed DidiDepartment of Endocrinology, Alder Hey Children's NHS Foundation Trust, Liverpool, L12 2AP, UK. mohammed.didi@alderhey.nhs.uk.
Keith ThornboroughDepartment of Diabetes, Alder Hey Children's NHS Foundation Trust, Liverpool, L12 2AP, UK. keith.thornborough@alderhey.nhs.uk.
Emma BedsonLiverpool Clinical Trials Research Centre, Liverpool, L12 2AP, UK. E.Bedson@liverpool.ac.uk.
Lola AwoyaleLiverpool Clinical Trials Research Centre, Liverpool, L12 2AP, UK. L.Awoyale@liverpool.ac.uk.
Emma CwiklinskiLiverpool Clinical Trials Research Centre, Liverpool, L12 2AP, UK. E.Cwiklinski@liverpool.ac.uk.
Matthew PeakDepartment of Research, Alder Hey Children's NHS Foundation Trust, Liverpool, L12 2AP, UK. matthew.peak@alderhey.nhs.uk.
Alder Hey Children's NHS Foundation Trust · GBBangor University · GBCardiff University · GB

Funding

Department of Health 08/14/39
6 · The paper itself

Abstract

backgroundIntensive insulin therapy with continuous subcutaneous insulin infusion (CSII) devices or multiple daily injections (MDI) reduces the risk of long-term vascular complications of type I diabetes (TID). Both treatments are used routinely, but there is little evidence to demonstrate superiority of either treatment. If CSII treatment reduces the risk of long-term complications or is associated with an improved quality of life (QoL), the additional cost of this therapy may be compensated for by a reduction in long-term health expenditure. If there is no demonstrable difference between treatments, health-care resources may be better invested elsewhere. This study aims to address this gap in knowledge. METHODS/

designThis is a pragmatic, randomised controlled trial (RCT). Fifteen centres, selected to represent a population with a broad demographic, will recruit 316 patients, newly diagnosed with TID, aged between 7 months and 15 years. Exclusion criteria include additional pathologies or treatments likely to affect glycaemic control and a first-degree relative with TID. Randomisation to CSII or MDI is stratified for age, gender and recruiting centre. The randomised treatment starts within 15 days of diagnosis. Patients will be trained to adjust their insulin dose according to carbohydrate intake and blood glucose level. Study visits coincide with routine clinic appointments at 3, 6, 9 and 12 months when data relating to routine clinical assessments, adverse events and concomitant medications are collected. Health utilities questionnaires are completed at each visit and a diabetes-specific QoL questionnaire (PedsQL) at diagnosis, 6 and 12 months. The primary outcome is glycaemic control (HbA1c) at 12 months. Secondary outcome measures include QoL, insulin use, growth and weight gain, adverse events and a health economics appraisal. DISCUSSION: This is the first adequately powered RCT comparing CSII and MDI in a non-selected population, treated according to standard practice guidelines. It will produce data that are meaningful to individual patients and local and national policymakers.

trial registrationThe study was registered with the European Clinical Trials Database on 4 November 2010, reference 2010-023792-25.

Indexed as

Clinical ProtocolsAdolescentChildChild, PreschoolDiabetes Mellitus, Type 1HumansInfantInfusions, SubcutaneousInjectionsInsulinOutcome Assessment, Health CareQuality of LifeInsulin

Identifiers

PMID25873144
PMCPMC4410001
OpenAlexW2131097476

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.