Evidence map›Paper›PMID 31823314›Full record

Trial reportJournal of general internal medicine2020

Translating CKD Research into Primary Care Practice: a Group-Randomized Study.

Cara B Litvin, Paul J Nietert, Ruth G Jenkins, Andrea M Wessell, Lynne S Nemeth, Steven M Ornstein

Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
0.8field-weighted citation impact, top 18% 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

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Education programmes for people with chronic kidney disease and diabetes.The Cochrane database of systematic reviews · 2024
    Pooled it
  3. Trial
  4. Determinants of primary healthcare physicians' knowledge of diabetic kidney disease.African journal of primary health care & family medicine · 2026
    Article
  5. Article
  6. Article
  7. 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

6 authors at 1 institution in 1 country.

Cara B LitvinDivision of General Internal Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA. litvincb@musc.edu.
Paul J NietertDepartment of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
Ruth G JenkinsDepartment of Family Medicine, Medical University of South Carolina, Charleston, SC, USA.
Andrea M WessellDepartment of Family Medicine, Medical University of South Carolina, Charleston, SC, USA.
Lynne S NemethCollege of Nursing, Medical University of South Carolina, Charleston, SC, USA.
Steven M OrnsteinDepartment of Family Medicine, Medical University of South Carolina, Charleston, SC, USA.
Medical University of South Carolina · US

Funding

Translating CKD Research into Primary Care PracticeR18DK110962 · NIDDK · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI LITVIN, CARA B., ORNSTEIN, STEVEN M · 2016 to 2017
$668k
Medical Research Council MR/N005953/1NIDDK NIH HHS R18 DK110962NIDDK NIH HHS R18DK110962
6 · The paper itself

Abstract

backgroundChronic kidney disease (CKD) is common in the primary care setting. Early interventions may prevent progression of renal disease and reduce risk for cardiovascular complications, yet quality gaps have been documented. Successful approaches to improve identification and management of CKD in primary care are needed.

objectiveTo assess whether implementation of a primary care improvement model results in improved identification and management of CKD

design18-month group-randomized study

participants21 primary care practices in 13 US states caring for 107,094 patients

interventionsTo promote implementation of CKD improvement strategies, intervention practices received clinical quality measure (CQM) reports at least quarterly, hosted an on-site visit and 2 webinars, and sent clinician/staff representatives to a "best practice" meeting. Control practices received CQM reports at least quarterly. MAIN MEASURES: Changes in practice adherence to a set of 11 CKD CQMs KEY

resultsWe observed significantly greater improvements among intervention practices for annual screening for albuminuria in patients with diabetes or hypertension (absolute change 22% in the intervention group vs. - 2.6% in the control group, p < 0.0001) and annual monitoring for albuminuria in patients with CKD (absolute change 21% in the intervention group vs. - 2.0% in the control group, p < 0.0001). Avoidance of NSAIDs in patients with CKD declined in both intervention and control groups, with a significantly greater decline in the control practices (absolute change - 5.0% in the intervention group vs. - 10% in the control group, p < 0.0001). There were no other significant changes found for the other CQMs. Variable implementation of CKD improvement strategies was noted across the intervention practices.

conclusionsImplementation of a primary care improvement model designed to improve CKD identification and management resulted in significantly improved care on 3 out of 11 CQMs. Incomplete adoption of improvement strategies may have limited further improvement. Improving CKD identification and management likely requires a longer and more intensive intervention.

Indexed as

Diabetes MellitusHypertensionRenal Insufficiency, ChronicHumansMass ScreeningPrimary Health Carechronic kidney diseaseprimary carequality improvement

Identifiers

PMID31823314
PMCPMC7210359
OpenAlexW2996659540

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.