Evidence map›Paper›PMID 32876576›Full record

ArticleJMIR formative research2020

Guiding Glucose Management Discussions Among Adults With Type 2 Diabetes in General Practice: Development and Pretesting of a Clinical Decision Support Tool Prototype Embedded in an Electronic Medical Record.

Breanne E Kunstler, John Furler, Elizabeth Holmes-Truscott, Hamish McLachlan, Douglas Boyle, Sean Lo, Jane Speight, David O'Neal, Ralph Audehm, Gary Kilov and 1 more

Open access · goldAbstract read
In one paragraph

Article in JMIR formative research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.7field-weighted citation impact, top 28% 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

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Best Practice Alert to Promote Screening for Primary Aldosteronism Among People With Apparent Treatment-Resistant Hypertension.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2024
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  5. Review
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

11 authors at 2 institutions in 1 country.

Breanne E KunstlerDepartment of General Practice, University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0002-0334-6918
John FurlerDepartment of General Practice, University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0003-0339-5848
Elizabeth Holmes-TruscottSchool of Psychology, Deakin University, Geelong, Victoria, Australia.ORCID https://orcid.org/0000-0001-9139-4663
Hamish McLachlanDepartment of General Practice, University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0002-5704-6419
Douglas BoyleDepartment of General Practice, University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0002-4779-7083
Sean LoDepartment of General Practice, University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0001-7575-0314
Jane SpeightSchool of Psychology, Deakin University, Geelong, Victoria, Australia.ORCID https://orcid.org/0000-0002-1204-6896
David O'NealDepartment of Medicine, St Vincent's Hospital, University of Melbourne, Melbourne, Australia.ORCID https://orcid.org/0000-0002-0870-4032
Ralph AudehmDepartment of General Practice, University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0001-9136-8772
Gary KilovDepartment of General Practice, University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0002-8845-1468
Jo-Anne Manski-NankervisDepartment of General Practice, University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0003-2153-3482
The University of Melbourne · AUDeakin University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundManaging type 2 diabetes (T2D) requires progressive lifestyle changes and, sometimes, pharmacological treatment intensification. General practitioners (GPs) are integral to this process but can find pharmacological treatment intensification challenging because of the complexity of continually emerging treatment options.

objectiveThis study aimed to use a co-design method to develop and pretest a clinical decision support (CDS) tool prototype (GlycASSIST) embedded within an electronic medical record, which uses evidence-based guidelines to provide GPs and people with T2D with recommendations for setting glycated hemoglobin (HbA1c) targets and intensifying treatment together in real time in consultations.

methodsThe literature on T2D-related CDS tools informed the initial GlycASSIST design. A two-part co-design method was then used. Initial feedback was sought via interviews and focus groups with clinicians (4 GPs, 5 endocrinologists, and 3 diabetes educators) and 6 people with T2D. Following refinements, 8 GPs participated in mock consultations in which they had access to GlycASSIST. Six people with T2D viewed a similar mock consultation. Participants provided feedback on the functionality of GlycASSIST and its role in supporting shared decision making (SDM) and treatment intensification.

resultsClinicians and people with T2D believed that GlycASSIST could support SDM (although this was not always observed in the mock consultations) and individualized treatment intensification. They recommended that GlycASSIST includes less information while maintaining relevance and credibility and using graphs and colors to enhance visual appeal. Maintaining clinical autonomy was important to GPs, as they wanted the capacity to override GlycASSIST's recommendations when appropriate. Clinicians requested easier screen navigation and greater prescribing guidance and capabilities.

conclusionsGlycASSIST was perceived to achieve its purpose of facilitating treatment intensification and was acceptable to people with T2D and GPs. The GlycASSIST prototype is being refined based on these findings to prepare for quantitative evaluation.

Indexed as

clinical decision supportgeneral practiceprimary careshared decision makingtype 2 diabetes

Identifiers

PMID32876576
PMCPMC7495264
OpenAlexW3046107819

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.