Evidence map›Paper›PMID 26465127›Full record

ArticleMedical care2015

Do Patients at Sites With High RCT Enrollment Propensity Have Better Outcomes?

Alistair J O'Malley, Katya Zelevinsky, Yulei He, Alisa B Busch

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

Article in Medical care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 88% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Clinicians' Perceptions of Rapid Scale-up of Telehealth Services in Outpatient Mental Health Treatment.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2021
    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

4 authors at 4 institutions in 1 country.

Alistair J O'Malley*Department of Biomedical Data Science and The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH †Department of Health Care Policy, Harvard Medical School, Boston, MA ‡Office of Research and Methodology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD §McLean Hospital, Belmont, MA ∥Department of Psychiatry, Harvard Medical School, Boston, MA.
Katya Zelevinsky
Yulei He
Alisa B Busch
Centers for Disease Control and Prevention · USDartmouth Institute for Health Policy and Clinical Practice · USHarvard University · USMcLean Hospital · US

Funding

Accounting for confounding bias and heterogeneity in comparative effectivenessRC4MH092717 · NIMH · HARVARD MEDICAL SCHOOL · PI O'MALLEY, ALISTAIR JAMES · 2010 to 2010
$1.5M
Quality of Care for Bipolar DisorderK01MH071714 · NIMH · HARVARD MEDICAL SCHOOL · PI BUSCH, ALISA B · 2006 to 2010
$886k
NIMH NIH HHS K01 MH071714NIMH NIH HHS RC4 MH092717
6 · The paper itself

Abstract

backgroundConcerns about randomized controlled trial (RCT) generalizability typically center on characteristics of RCT patient participants. Possibly there are RCT site characteristics that distinguish RCT outcomes from those that can be expected in non-RCT settings.

objectivesTo examine whether site propensity toward RCT enrollment is associated with recovery outcomes for patients and whether the association differs between patients who participate in a RCT compared with those who remain in an observational (OBS) treatment environment. DATA: Study participants with acute bipolar depression from The Systematic Treatment Enhancing Program for Bipolar Disorder acute depression pharmacotherapy RCT (N=337) and OBS treatment arm (N=1581).

methodsA longitudinal OBS study comparing the likelihood of recovery in the RCT to the OBS arm, allowing effect modification by site high RCT enrollment propensity (defined as >the median) and other predictors over a 6-month follow-up period.

resultsNon-RCT participants who received care in sites with high RCT enrollment propensity had a higher probability of recovering from their bipolar-depression episode compared with participants from low propensity sites [odds ratio (95% confidence interval)=2.13 (1.28-3.55)]. RCT enrollment propensity was not associated with recovery outcomes for RCT participants [1.03 (0.35-3.03)].

conclusionsSites with high propensity to enroll patients in RCTs appear to have unobserved characteristics, which play a significant role in outcomes for non-RCT patients. For RCT participants in low-enrollment sites, possibly RCT protocols, which proscribe care delivery and monitoring, attenuate this effect. These results have implications for future research to improve outcomes in nonresearch care settings.

Indexed as

Outcome Assessment, Health CareResearch SubjectsAdultBipolar DisorderFemaleHumansLongitudinal StudiesMaleObservational Studies as TopicPatient ParticipationPatient SelectionPrognosisRandomized Controlled Trials as Topic

Identifiers

PMID26465127
PMCPMC4672722
OpenAlexW2249205900

What OpenQuestion holds

Textmetadata
LicenceTDM
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.