Evidence map›Paper›PMID 28137784›Full record

Observational studyThe British journal of general practice : the journal of the Royal College of General Practitioners2017

Reducing liver function tests for statin monitoring: an observational comparison of two clinical commissioning groups.

Kate Homer, John Robson, Susannah Solaiman, Abigail Davis, Saima Zubeda Khan, David McCoy, Rohini Mathur, Sally Hull, Kambiz Boomla

Open access · bronzeAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The British journal of general practice : the journal of the Royal College of General Practitioners, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.7field-weighted citation impact, top 16% 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

6 citing papers in PubMed, 13 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Article
  6. Progress in using the electronic health record to improve primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020
    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

9 authors at 1 institution in 1 country.

Kate HomerCentre for Primary Care and Public Health, Queen Mary University of London, London.
John RobsonCentre for Primary Care and Public Health, Queen Mary University of London, London.
Susannah SolaimanCentre for Primary Care and Public Health, Queen Mary University of London, London.
Abigail DavisCentre for Primary Care and Public Health, Queen Mary University of London, London.
Saima Zubeda KhanCentre for Primary Care and Public Health, Queen Mary University of London, London.
David McCoyCentre for Primary Care and Public Health, Queen Mary University of London, London.
Rohini MathurCentre for Primary Care and Public Health, Queen Mary University of London, London.
Sally HullCentre for Primary Care and Public Health, Queen Mary University of London, London.
Kambiz BoomlaCentre for Primary Care and Public Health, Queen Mary University of London, London.
Queen Mary University of London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent liver function testing for statin monitoring is largely unnecessary and costly. Statins do not cause liver disease. Both reduction in test frequency and use of a single alanine transaminase (ALT) rather than a full seven analyte liver function test (LFT) array would reduce cost and may benefit patients.

aimTo assess LFT testing in relation to statin use and evaluate an intervention to reduce full-array LFTs ordered by GPs for statin monitoring. DESIGN AND

settingTwo-year cross-sectional time series in two east London clinical commissioning groups (CCGs) with 650 000 patients. One CCG received the intervention; the other did not.

methodThe intervention comprised local guidance on LFTs for statin monitoring and access to a single ALT rather than full LFT array.

resultsOf the total population, 17.6% were on statins, accounting for 43.2% of total LFTs. In the population without liver disease, liver function tests were 3.6 times higher for those on statins compared with those who were not. Following intervention there was a significant reduction in the full LFT array per 1000 people on statins, from 70.3 (95% confidence interval [CI] = 66.3 to 74.6) in the pre-intervention year, to 58.1 (95% CI = 55.5 to 60.7) in the post-intervention year (

conclusionThis simple and generalisable intervention, enabling ordering of a single ALT combined with information recommending prudent rather than periodic testing, reduced full LFT testing by 24.3% in people on statins. This is likely to have patient benefit at reduced cost.

Indexed as

Advisory CommitteesAdultAlanine TransaminaseCost-Benefit AnalysisCross-Sectional StudiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLiver DiseasesLiver Function TestsPractice Patterns, Physicians'Alanine TransaminaseHydroxymethylglutaryl-CoA Reductase Inhibitorsdiagnostic tests, statinsliver function testsprimary health carequality improvementunnecessary procedures

Identifiers

PMID28137784
PMCPMC5325661
OpenAlexW2582997205

What OpenQuestion holds

Textmetadata
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.