Evidence map›Paper›PMID 26459461›Full record

ArticleJournal of neurogastroenterology and motility2016

Balance of Autonomic Nervous System Predicts Who Benefits from a Self-management Intervention Program for Irritable Bowel Syndrome.

Monica E Jarrett, Kevin C Cain, Pamela G Barney, Robert L Burr, Bruce D Naliboff, Robert Shulman, Jasmine Zia, Margaret M Heitkemper

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurogastroenterology and motility, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 4 pooled it
2.8field-weighted citation impact, top 10% 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

35 citing papers in PubMed, 4 syntheses or guidelines pooled it, 49 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 4 institutions in 1 country.

Monica E JarrettDepartment of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA.
Kevin C CainDeptartment of Biostatistics and Office for Nursing Research, University of Washington, Seattle, WA, USA.
Pamela G BarneyDepartment of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA.
Robert L BurrDepartment of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA.
Bruce D NaliboffCenter for Neurovisceral Sciences & Women's Health, University of California Los Angeles, Los Angeles, CA, USA.
Robert ShulmanBaylor College of Medicine, Houston, TX, USA.
Jasmine ZiaDepartment of Medicine, University of Washington, Seattle, WA, USA.
Margaret M HeitkemperDepartment of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA.
University of Washington · USNeurobehavioral Systems · USBaylor College of Medicine · USUniversity of California, Los Angeles · US

Funding

NURSING MANAGEMENT OF IBS--IMPROVING OUTCOMESR01NR004142 · NINR · UNIVERSITY OF WASHINGTON · PI HEITKEMPER, MARGARET MCLEAN · 1996 to 2011
$5.5M
NINR NIH HHS R01 NR004142
6 · The paper itself

Abstract

BACKGROUND/

aimsTo determine if potential biomarkers can be used to identify subgroups of people with irritable bowel syndrome (IBS) who will benefit the most or the least from a comprehensive self-management (CSM) intervention.

methodsIn a two-armed randomized controlled trial a CSM (n = 46) was compared to a usual care (n = 46) group with follow-up at 3 and 6 months post randomization. Biomarkers obtained at baseline included heart rate variability, salivary cortisol, interleukin-10 produced by unstimulated peripheral blood mononuclear cells, and lactulose/mannitol ratio. Linear mixed models were used to test whether these biomarkers predicted improvements in the primary outcomes including daily abdominal pain, Gastrointestinal Symptom score and IBS-specific quality of life.

resultsThe nurse-delivered 8-session CSM intervention is more effective than usual care in reducing abdominal pain, reducing Gastrointestinal Symptom score, and enhancing quality of life. Participants with lower nighttime high frequency heart rate variability (vagal modulation) and increased low frequency/high frequency ratio (sympathovagal balance) had less benefit from CSM on abdominal pain. Salivary cortisol, IL-10, and lactulose/mannitol ratio were not statistically significant in predicting CSM benefit. Baseline symptom severity interacts with treatment, namely the benefit of CSM is greater in those with higher baseline symptoms.

conclusionsCognitively-focused therapies may be less effective in reducing abdominal pain in IBS patients with higher sympathetic tone. Whether this a centrally-mediated patient characteristic or related to heightened arousal remains to be determined.

Indexed as

Autonomic nervous systemInterleukin 10Irritable bowel syndromePermeability

Identifiers

PMID26459461
PMCPMC4699727
OpenAlexW2329552564

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.