Evidence map›Paper›PMID 28069625›Full record

Trial reportBMJ open2017

Cost-effectiveness of a pragmatic structured education intervention for the prevention of type 2 diabetes: economic evaluation of data from the Let's Prevent Diabetes cluster-randomised controlled trial.

J Leal, D Ahrabian, M J Davies, L J Gray, K Khunti, T Yates, A M Gray

Open access · goldAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
19.8field-weighted citation impact, top 1% 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

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Article
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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

7 authors at 2 institutions in 1 country.

J LealNuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, UK.ORCID 0000-0001-7870-6730
D AhrabianNuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, UK.
M J DaviesDiabetes Research Centre, University of Leicester, Leicester, UK.
L J GrayDepartment of Health Sciences, University of Leicester, Leicester, UK.ORCID 0000-0003-0239-7278
K KhuntiDiabetes Research Centre, University of Leicester, Leicester, UK.
T YatesDiabetes Research Centre, University of Leicester, Leicester, UK.
A M GrayNuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, UK.
University of Leicester · GBUniversity of Oxford · GB

Funding

Department of Health RP-PG-0606-1272Medical Research Council G0801042
6 · The paper itself

Abstract

objectivesPrevention of type 2 diabetes mellitus (TD2M) is a priority for healthcare systems. We estimated the cost-effectiveness compared with standard care of a structured education programme (Let's Prevent) targeting lifestyle and behaviour change to prevent progression to T2DM in people with prediabetes.

designCost-effectiveness analysis alongside randomised controlled trial.

setting44 general practices in Leicestershire, England.

participants880 participants with prediabetes randomised to receive either standard care or a 6-hour group structured education programme with follow-up sessions in a primary care setting.

main outcome measureIncremental cost utility from the UK National Health Service (NHS) perspective. Quality of life and resource use measured from baseline and during the 36 months follow-up using the EuroQoL EQ-5D and 15D instruments and an economic questionnaire. Outcomes measured using quality-adjusted life years (QALYs) and healthcare costs calculated in 2012-2013 prices.

resultsAfter accounting for clustering and missing data, the intervention group was found to have a net gain of 0.046 (95% CI -0.0171 to 0.109) QALYs over 3 years, adjusted for baseline utility, at an additional cost of £168 (95% CI -395 to 732) per patient compared with the standard care group. The incremental cost-effectiveness ratio is £3643/QALY with an 86% probability of being cost-effective at a willingness to pay threshold of £20 000/QALY.

conclusionsThe education programme had higher costs and higher quality of life compared with the standard care group. The Let's Prevent programme is very likely to be cost-effective at a willingness to pay threshold of £20 000/QALY gained. TRIAL REGISTRATION NUMBER: ISRCTN80605705.

Indexed as

AdultCost-Benefit AnalysisDiabetes Mellitus, Type 2FemaleHealth ExpendituresHealth ResourcesHealthy LifestyleHospitalizationHumansHypoglycemic AgentsMalePatient Education as TopicQuality-Adjusted Life YearsQuality of LifeHypoglycemic AgentsDIABETES & ENDOCRINOLOGYHEALTH ECONOMICSPREVENTIVE MEDICINEPRIMARY CARE

Identifiers

PMID28069625
PMCPMC5223732
OpenAlexW2567877089

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.