Evidence map›Paper›PMID 31843821›Full record

ArticleBMJ open2019

DIVERT-Collaboration Action Research and Evaluation (CARE) Trial Protocol: a multiprovincial pragmatic cluster randomised trial of cardiorespiratory management in home care.

Andrew P Costa, Connie Schumacher, Aaron Jones, Darly Dash, Graham Campbell, Mats Junek, Gina Agarwal, Chaim M Bell, Veronique Boscart, Susan E Bronskill and 14 more

Registry-linked trialOpen access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03012256 (The DIVERT-CARE), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
7.3field-weighted citation impact, top 3% 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.

NCT03012256 nacompletednot on this map

The DIVERT-CARE (Collaboration Action Research & Evaluation) Trial: A Multi Provincial Pragmatic Cluster Randomized Trial of Cardio-Respiratory Management in Home Care

TypeinterventionalSponsorMcMaster UniversityRan2018 to 2020Enrolled896ConditionsHeart Failure, CopdArmsCardio-respiratory management model
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. 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

24 authors at 12 institutions in 1 country.

Andrew P CostaDepartment of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada acosta@mcmaster.ca.ORCID 0000-0001-9212-5641
Connie SchumacherDepartment of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Aaron JonesDepartment of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Darly DashDepartment of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Graham CampbellDepartment of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Mats JunekDepartment of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Gina AgarwalDepartment of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-5691-4675
Chaim M BellDepartment of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
Veronique BoscartSchlegel Centre for Advancing Seniors Care, Conestoga College Institute of Technology and Advanced Learning, Kitchener, Ontario, Canada.ORCID 0000-0002-7420-1978
Susan E BronskillInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
David FeenyDepartment of Economics, McMaster University, Hamilton, Ontario, Canada.
Paul C HébertDepartment of Medicine, Universite de Montreal, Montreal, Québec, Canada.
George A HeckmanSchool of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
John P HirdesSchool of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
Linda LeeDepartment of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
Robert S McKelvieDepartment of Medicine, Western University, London, Ontario, Canada.
Lori MitchellHome Care, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada.
Samir K SinhaDepartments of Medicine, Family and Community Medicine, and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Joy DavisInformation Management, Western Health Care Corp, Corner Brook, Newfoundland, Canada.
Tammy PriddleCommunity Support, Western Health Care Corp, Corner Brook, Newfoundland, Canada.
Joanne RoseDepartment of Health and Community Services, Government of Newfoundland and Labrador, Saint John's, Newfoundland, Canada.
Roslyn GillanCommunity Health Services, Island Health, Victoria, British Columbia, Canada.
Deborah MillsCommunity Health Services, Island Health, Victoria, British Columbia, Canada.
Dilys HaughtonHamilton Niagara Haldimand Brant Local Health Integration Network, Hamilton, Ontario, Canada.
Impact · CAIsland Health · CAMcMaster University · CAUniversity of Waterloo · CAConestoga College · CAGovernment of Newfoundland and Labrador · CAInstitute for Clinical Evaluative Sciences · CAMount Sinai Hospital · CAUniversité de Montréal · CAUniversity of Toronto · CAWestern University · CAWinnipeg Regional Health Authority · CA

Funding

CIHR 148933
6 · The paper itself

Abstract

introductionHome care clients are increasingly medically complex, have limited access to effective chronic disease management and have very high emergency department (ED) visitation rates. There is a need for more appropriate and targeted supportive chronic disease management for home care clients. We aim to evaluate the effectiveness and preliminary cost effectiveness of a targeted, person-centred cardiorespiratory management model. METHODS AND ANALYSIS: The Detection of Indicators and Vulnerabilities of Emergency Room Trips (DIVERT) - Collaboration Action Research and Evaluation (CARE) trial is a pragmatic, cluster-randomised, multicentre superiority trial of a flexible multicomponent cardiorespiratory management model based on the best practice guidelines. The trial will be conducted in partnership with three regional, public-sector, home care providers across Canada. The primary outcome of the trial is the difference in time to first unplanned ED visit (hazard rate) within 6 months. Additional secondary outcomes are to identify changes in patient activation, changes in cardiorespiratory symptom frequencies and cost effectiveness over 6 months. We will also investigate the difference in the number of unplanned ED visits, number of inpatient hospitalisations and changes in health-related quality of life. Multilevel proportional hazard and generalised linear models will be used to test the primary and secondary hypotheses. Sample size simulations indicate that enrolling 1100 home care clients across 36 clusters (home care caseloads) will yield a power of 81% given an HR of 0.75. ETHICS AND DISSEMINATION: Ethics approval was obtained from the Hamilton Integrated Research Ethics Board as well as each participating site's ethics board. Results will be submitted for publication in peer-reviewed journals and for presentation at relevant conferences. Home care service partners will also be informed of the study's results. The results will be used to inform future support strategies for older adults receiving home care services. TRIAL REGISTRATION NUMBER: NCT03012256.

Indexed as

Heart FailureHome Care ServicesRespiratory InsufficiencyCanadaCost-Benefit AnalysisEmergency Service, HospitalEquivalence Trials as TopicFacilities and Services UtilizationHospitalizationHumansMulticenter Studies as TopicPragmatic Clinical Trials as TopicProportional Hazards ModelsQuality of LifeTime-to-Treatmentcardio-respiratorychronic disease managementcluster-randomiseddisease managementDIVERT scalehome care

Identifiers

PMID31843821
PMCPMC6924743
OpenAlexW2995051075

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.