Evidence map›Paper›PMID 28531281›Full record

Trial reportEuropean heart journal2017

Standard vs. intensified management of heart failure to reduce healthcare costs: results of a multicentre, randomized controlled trial.

P A Scuffham, J Ball, J D Horowitz, C Wong, P J Newton, P Macdonald, J McVeigh, A Rischbieth, N Emanuele, M J Carrington and 4 more

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

Trial report in European heart journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
3.2field-weighted citation impact, top 7% 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, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Improvement in left ventricular ejection fraction after pharmacological up-titration in new-onset heart failure with reduced ejection fraction.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2021
    Article
  4. Review
  5. Review
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 10 institutions in 1 country.

P A ScuffhamCentre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, N78_2.42 The Circuit, Nathan, Queensland 4111, Australia.
J BallPre-Clinical Disease and Prevention, Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, Victoria 3004, Australia.
J D HorowitzDepartment of Cardiology, Queen Elizabeth Hospital, University of Adelaide, North Terrace, Adelaide, South Australia 5000, Australia.
C WongDepartment of Cardiology, Western Health (Footscray Hospital), Melbourne Medical School, The University of Melbourne, Grattan St, Parkville, Victoria 3010, Australia.
P J NewtonCentre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney, 235 Jones St, Ultimo, New South Wales 2007, Australia.
P MacdonaldHeart Failure and Transplant Unit, St Vincent's Hospital, 390 Victoria St, Darlinghurst, Sydney, NSW 2010, Australia.
J McVeighDepartment of Cardiology, Prince of Wales Hospital, Barker St, Randwick, NSW 2031, Australia.
A RischbiethNational Heart Foundation of Australia, 500 Collins St Melbourne, Victoria 3000, Australia.
N EmanueleNational Heart Foundation of Australia, 500 Collins St Melbourne, Victoria 3000, Australia.
M J CarringtonPre-Clinical Disease and Prevention, Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, Victoria 3004, Australia.
C M ReidNHMRC Centre of Research Excellence in Cardiovascular Outcomes Improvement, Curtin University, Kent St, Bentley, Western Australia 6102, Australia.
Y K ChanMary MacKillop Institute for Health Research, NHMRC of Australia Centre of Research Excellence to Reduce Inequality in Heart Disease, Australian Catholic University, Level 5, 215 Spring St, Melbourne, Victoria 3000, Australia.
S StewartMary MacKillop Institute for Health Research, NHMRC of Australia Centre of Research Excellence to Reduce Inequality in Heart Disease, Australian Catholic University, Level 5, 215 Spring St, Melbourne, Victoria 3000, Australia.
WHICH? II Trial Investigators
Baker Heart and Diabetes Institute · AUNational Health and Medical Research Council · AUUniversity of Adelaide · AUAustralian Catholic University · AUGriffith University · AUNational Heart Foundation of Australia · AUPrince of Wales Hospital · AUSt Vincent's Hospital Sydney · AUUniversity of Melbourne · AUUniversity of Technology Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo determine if an intensified form of heart failure management programme (INT-HF-MP) based on individual profiling is superior to standard management (SM) in reducing health care costs during 12-month follow-up (primary endpoint). METHODS AND

resultsA multicentre randomized trial involving 787 patients (full analysis set) discharged from four tertiary hospitals with chronic HF who were randomized to SM (n = 391) or INT-HF-MP (n = 396). Mean age was 74 ± 12 years, 65% had HF with a reduced ejection fraction (31.4 ± 8.9%) and 14% were remote-dwelling. Study groups were well matched. According to Green, Amber, Red Delineation of rIsk And Need in HF (GARDIAN-HF) profiling, regardless of location, patients in the INT-HF-MP received a combination of face-to-face (home visits) and structured telephone support (STS); only 9% (`low risk') were designated to receive the same level of management as the SM group. The median cost in 2017 Australian dollars (A$1 equivalent to ∼EUR €0.7) of applying INT-HF-MP was significantly greater than SM ($152 vs. $121 per patient per month; P < 0.001), However, at 12 months, there was no difference in total health care costs for the INT-HF-MP vs. SM group (median $1579, IQR $644 to $3717 vs. $1450, IQR $564 to $3615 per patient per month, respectively). This reflected minimal differences in all-cause mortality (17.7% vs. 18.4%; P = 0.848) and recurrent hospital stay (18.6 ± 26.5 vs. 16.6 ± 24.8 days; P = 0.199) between the INT-HF-MP and SM groups, respectively.

conclusionDuring 12-months follow-up, an INT-HF-MP did not reduce healthcare costs or improve health outcomes relative to SM.

Indexed as

AgedAustraliaChronic DiseaseFemaleHealth Care CostsHeart FailureHospitalizationHumansMalePatient Care TeamTreatment OutcomeHealthcare costsHeart failureHospitalizationMortalityMultidisciplinary managementNurse-led

Identifiers

PMID28531281
PMCPMC5843128
OpenAlexW2614942268

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.