Evidence map›Paper›PMID 26268736›Full record

ArticleCardiovascular diabetology2015

Long-term effects of the multidisciplinary risk assessment and management program for patients with diabetes mellitus (RAMP-DM): a population-based cohort study.

Fangfang Jiao, Colman Siu Cheung Fung, Yuk Fai Wan, Sarah Morag McGhee, Carlos King Ho Wong, Daisy Dai, Ruby Kwok, Cindy Lo Kuen Lam

Registry-linked trialOpen access · goldAbstract readControlled Clinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiovascular diabetology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02034695 (Evaluation of Quality of Care - Risk Assessment Management Programme, HA), which is not on this map. Cited by 22 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 3 pooled it
5.7field-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.

NCT02034695 completednot on this map

Evaluation of Quality of Care - Risk Assessment Management Programme, HA

TypeobservationalSponsorThe University of Hong KongRan2010 to 2017Enrolled2,496ConditionsDiabetes Mellitus
3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 56 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

8 authors at 2 institutions in 2 countries.

Fangfang JiaoDepartment of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong. francesj@connect.hku.hk.
Colman Siu Cheung FungDepartment of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong. cfsc@hku.hk.
Yuk Fai WanDepartment of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong. yfwan@hku.hk.
Sarah Morag McGheeSchool of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong. smmcghee@hkucc.hku.hk.
Carlos King Ho WongDepartment of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong. carlosho@hku.hk.
Daisy DaiPrimary and Community Services, Hospital Authority Head Office, Hong Kong Hospital Authority, Hospital Authority Building, 147B Argyle Street, Kowloon, Hong Kong. ddai@ha.org.hk.
Ruby KwokPrimary and Community Services, Hospital Authority Head Office, Hong Kong Hospital Authority, Hospital Authority Building, 147B Argyle Street, Kowloon, Hong Kong. kwoklp@ha.org.hk.
Cindy Lo Kuen LamDepartment of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong. clklam@hku.hk.
University of Hong Kong · HKHospital Authority · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStudies on the long-term effectiveness of multidisciplinary risk-stratification based management in Chinese population were rare. This study aimed to evaluate the effectiveness of a multidisciplinary risk assessment and management program for patients with diabetes mellitus (RAMP-DM) in reducing the risks of cardiovascular complications and all-cause mortality.

methodsA prospective cohort study was conducted in 18,188 propensity score matched RAMP-DM participants and subjects with diabetes under usual primary care (9,094 subjects in each group). The study endpoints were the first occurrence of coronary heart disease (CHD), stroke, heart failure (HF), total cardiovascular disease (CVD) and all-cause mortality. We constructed multivariable Cox proportional hazard regressions to estimate the association between the RAMP-DM intervention and the first occurrence of study endpoints.

resultsThe median follow-up period was 36 months. Three hundred and ninety-nine CVD events occurred in the RAMP-DM group, as compared with 608 in the control group [adjusted hazard ratio, 0.629; 95% confidence interval (CI) 0.554-0.715; P < 0.001]. The total number of all-cause deaths in RAMP-DM group was less than half that of control group (202 vs 552, adjusted hazard ratio, 0.363; 95% CI, 0.308-0.428; P < 0.001). The adjusted hazard ratios of the RAMP-DM group for CHD, stroke, and HF were 0.570 (95% CI, 0.470-0.691; P < 0.001), 0.652 (95% CI, 0.546-0.780; P < 0.001), and 0.598 (95%CI, 0.446-0.802; P = 0.001), respectively.

conclusionsThe RAMP-DM intervention was associated with lower incidences of individual and total cardiovascular complications, as well as all-cause mortality over 3 years follow-up. The encouraging results provided evidence to support that the structured risk-stratification management leading by a multidisciplinary clinical team was an effective approach to reduce future cardiovascular complications in people with diabetes. CLINICAL TRIAL REGISTRY: NCT02034695, http://www.ClinicalTrials.gov.

Indexed as

Preventive Health ServicesAgedCardiovascular DiseasesCause of DeathChi-Square DistributionComparative Effectiveness ResearchCoronary DiseaseDiabetes MellitusFemaleHealth Knowledge, Attitudes, PracticeHeart FailureHong KongHumansIncidenceIntention to Treat AnalysisKaplan-Meier Estimate

Identifiers

PMID26268736
PMCPMC4535739
OpenAlexW2160315896

What OpenQuestion holds

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LicenceCC BY
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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.