Evidence map›Paper›PMID 30022426›Full record

ArticleObesity surgery2018

Effective Implementation of Peri-operative Local Guidelines for Metabolic Surgery in Patients with Diabetes Mellitus in a Tier 4 Setting Demonstrate Improved Work Efficiency and Resource Allocation.

Neha Shah, Jenny Abraham, Wendy Goodwin, Hassan Kahal, Vinod Menon, F T Lam, Thomas M Barber

Abstract read
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In one paragraph

Article in Obesity surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
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.

Neha ShahDietetics, University Hospitals Coventry and Warwickshire, 2nd Floor Rotunda, Clifford Bridge Road, Coventry, CV2 2DX, UK. Neha.shah@uhcw.nhs.uk.ORCID 0000-0002-8105-3969
Jenny AbrahamDietetics, University Hospitals Coventry and Warwickshire, 2nd Floor Rotunda, Clifford Bridge Road, Coventry, CV2 2DX, UK.
Wendy GoodwinDietetics, University Hospitals Coventry and Warwickshire, 2nd Floor Rotunda, Clifford Bridge Road, Coventry, CV2 2DX, UK.
Hassan KahalDietetics, University Hospitals Coventry and Warwickshire, 2nd Floor Rotunda, Clifford Bridge Road, Coventry, CV2 2DX, UK.
Vinod MenonDietetics, University Hospitals Coventry and Warwickshire, 2nd Floor Rotunda, Clifford Bridge Road, Coventry, CV2 2DX, UK.
F T LamDietetics, University Hospitals Coventry and Warwickshire, 2nd Floor Rotunda, Clifford Bridge Road, Coventry, CV2 2DX, UK.
Thomas M BarberDietetics, University Hospitals Coventry and Warwickshire, 2nd Floor Rotunda, Clifford Bridge Road, Coventry, CV2 2DX, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDynamic changes in glycaemia predominate peri-operatively in patients with type 2 diabetes mellitus (T2DM) undergoing metabolic surgery. There is a lack of consensus and clear guidance on effective glycaemic management of such patients. The aim of this study was to design, pilot, and implement a proforma to improve consistency of glycaemic management and clarity of communication with healthcare professionals following metabolic surgery in patients with T2DM, thereby reducing unnecessary diabetes specialist nurse (DSN) referrals.

methodsA proforma was designed and piloted for 12 months to guide healthcare professionals on managing glycaemic therapies for T2DM patients undergoing metabolic surgery. Glycaemic control (HbA1c) and glycaemic therapies were reviewed 3 weeks pre-operatively and a proforma was completed accordingly.

resultsOf the patients with T2DM (n = 34) who underwent metabolic surgery prior to the new proforma being implemented, 71% (n = 24) had a DSN referral. Half of these referrals were deemed unnecessary by the DSNs. Of the patients with T2DM (n = 33) who underwent metabolic surgery following implementation of the proforma, 21% (n = 7) had a DSN referral. Only 10% of these were deemed unnecessary. Despite the reduced DSN input, no diabetes-related complications were reported.

conclusionImplementation of our proforma effectively halved the proportion of patients with T2DM requiring a DSN referral. Additionally, there was a 40% absolute reduction in the proportion of unnecessary DSN referrals. The proforma improved clarity of communication and guidance for healthcare professionals in the glycaemic management of patients. This also facilitated improved work efficiency and resource allocation.

Indexed as

Guideline AdherenceHealth Plan ImplementationResource AllocationWork PerformanceAdultBariatric SurgeryBlood GlucoseDiabetes Mellitus, Type 2FemaleGlycated HemoglobinHumansMaleMiddle AgedObesity, MorbidPerioperative CarePilot ProjectsBlood GlucoseGlycated HemoglobinGlycaemic control, sleeve gastrectomyMetabolic surgeryType 2 diabetes mellitus

Identifiers

PMID30022426

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.