Evidence map›Paper›PMID 27756796›Full record

ArticleCirculation. Cardiovascular quality and outcomes2016

Few Disparities in Baseline Laboratory Testing After the Diuretic or Digoxin Initiation by Medicare Fee-For-Service Beneficiaries.

Matthew L Maciejewski, Xiaojuan Mi, Lesley H Curtis, Judy Ng, Samuel C Haffer, Bradley G Hammill

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Cardiovascular quality and outcomes, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Observational
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.

Matthew L MaciejewskiFrom the Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, NC (M.L.M.); Division of General Internal Medicine, Department of Medicine (M.L.M., L.H.C.) and Duke Clinical Research Institute (X.M., L.H.C., B.G.H.), Duke University Medical Center, Durham, NC; National Committee for Quality Assurance, Washington, DC (J.N.); and Office of Minority Health, US Centers for Medicare and Medicaid Services, Baltimore, MD (S.C.H.). mlm34@duke.edu.
Xiaojuan MiFrom the Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, NC (M.L.M.); Division of General Internal Medicine, Department of Medicine (M.L.M., L.H.C.) and Duke Clinical Research Institute (X.M., L.H.C., B.G.H.), Duke University Medical Center, Durham, NC; National Committee for Quality Assurance, Washington, DC (J.N.); and Office of Minority Health, US Centers for Medicare and Medicaid Services, Baltimore, MD (S.C.H.).
Lesley H CurtisFrom the Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, NC (M.L.M.); Division of General Internal Medicine, Department of Medicine (M.L.M., L.H.C.) and Duke Clinical Research Institute (X.M., L.H.C., B.G.H.), Duke University Medical Center, Durham, NC; National Committee for Quality Assurance, Washington, DC (J.N.); and Office of Minority Health, US Centers for Medicare and Medicaid Services, Baltimore, MD (S.C.H.).
Judy NgFrom the Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, NC (M.L.M.); Division of General Internal Medicine, Department of Medicine (M.L.M., L.H.C.) and Duke Clinical Research Institute (X.M., L.H.C., B.G.H.), Duke University Medical Center, Durham, NC; National Committee for Quality Assurance, Washington, DC (J.N.); and Office of Minority Health, US Centers for Medicare and Medicaid Services, Baltimore, MD (S.C.H.).
Samuel C HafferFrom the Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, NC (M.L.M.); Division of General Internal Medicine, Department of Medicine (M.L.M., L.H.C.) and Duke Clinical Research Institute (X.M., L.H.C., B.G.H.), Duke University Medical Center, Durham, NC; National Committee for Quality Assurance, Washington, DC (J.N.); and Office of Minority Health, US Centers for Medicare and Medicaid Services, Baltimore, MD (S.C.H.).
Bradley G HammillFrom the Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, NC (M.L.M.); Division of General Internal Medicine, Department of Medicine (M.L.M., L.H.C.) and Duke Clinical Research Institute (X.M., L.H.C., B.G.H.), Duke University Medical Center, Durham, NC; National Committee for Quality Assurance, Washington, DC (J.N.); and Office of Minority Health, US Centers for Medicare and Medicaid Services, Baltimore, MD (S.C.H.).

Funding

Intramural VA VA999999
6 · The paper itself

Abstract

backgroundDespite the persistence of significant disparities, few evaluations examine disparities in laboratory testing by race/ethnicity, age, sex, Medicaid eligibility, and number of chronic conditions for Medicare fee-for-service beneficiaries' newly prescribed medications. In Medicare beneficiaries initiating diuretics or digoxin, this study examined disparities in guideline-appropriate baseline laboratory testing and abnormal laboratory values. METHODS AND

resultsTo evaluate guideline-concordant testing for serum creatinine and serum potassium within 180 days before or 14 days after the index prescription fill date, we constructed retrospective cohorts from 10 states of 99 711 beneficiaries who had heart failure or hypertension initiating diuretic in 2011 and 8683 beneficiaries who had heart failure or atrial fibrillation initiating digoxin. Beneficiaries initiating diuretics were less likely to have testing if they were non-Hispanic Black (relative risk [RR], 0.99; 95% confidence interval [CI], 0.98-0.99) than non-Hispanic White. Beneficiaries initiating diuretics and beneficiaries initiating digoxin were more likely to have testing if they had multiple chronic conditions relative to 0 to 1 conditions. Beneficiaries initiating diuretics with laboratory values were more likely to have an abnormal serum creatinine value at baseline if they were non-Hispanic Black (RR, 2.57; 95% CI, 1.91-3.44), other race (RR, 2.11; 95% CI, 1.08-4.10), or male (RR, 2.75; 95% CI, 2.14-3.52) or an abnormal serum potassium value if they were aged ≥76 years (RR, 1.29; 95% CI, 1.09-1.51) or male (RR, 1.17; 95% CI, 1.03-1.33).

conclusionsTesting rates were consistently high, so there were negligible disparities in guideline-concordant testing of creatinine and potassium after the initiation of digoxin or diuretics by Medicare beneficiaries.

Indexed as

AgedAge FactorsBiomarkersBlood Chemical AnalysisCardiovascular AgentsCardiovascular DiseasesCreatinineDatabases, FactualDigoxinDiureticsDrug MonitoringFee-for-Service PlansFemaleGuideline AdherenceHealthcare DisparitiesHumansBiomarkersCardiovascular AgentsCreatinineDigoxinDiureticsPotassiumatrial fibrillationcreatininedigoxinheart failureMedicarepotassiumsafety

Identifiers

PMID27756796
PMCPMC5339025

What OpenQuestion holds

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Registered trials

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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.