Evidence map›Paper›PMID 33565708›Full record

ArticleDiabetes, obesity & metabolism2021

Associations between attainment of incentivized primary care indicators and incident sight-threatening diabetic retinopathy in England: A population-based historical cohort study.

Ailsa J McKay, Laura H Gunn, Manjula D Nugawela, Thirunavukkarasu Sathish, Azeem Majeed, Eszter P Vamos, German Molina, Sobha Sivaprasad

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes, obesity & metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 37% 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

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Banting memorial lecture 2025: Aligning clinical practice, policy and research.Diabetic medicine : a journal of the British Diabetic Association · 2026
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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

8 authors at 5 institutions in 4 countries.

Ailsa J McKayDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Laura H GunnDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Manjula D NugawelaInstitute of Ophthalmology, UCL and NIHR Moorfields Biomedical Research Centre, London, UK.
Thirunavukkarasu SathishDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Azeem MajeedDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Eszter P VamosDepartment of Primary Care and Public Health, Imperial College London, London, UK.
German MolinaIdalion Capital Group, Charlotte, North Carolina, USA.
Sobha SivaprasadInstitute of Ophthalmology, UCL and NIHR Moorfields Biomedical Research Centre, London, UK.ORCID 0000-0001-8952-0659
Imperial College London · GBNIHR Moorfields Biomedical Research Centre · GBCapital Group (United States) · USNanyang Technological University · SGUniversity of North Carolina at Charlotte · US

Funding

Medical Research Council MR/P027881/1
6 · The paper itself

Abstract

aimTo examine the impact of attainment of primary care diabetes clinical indicators on progression to sight-threatening diabetic retinopathy (STDR) among those with mild non-proliferative diabetic retinopathy (NPDR). MATERIALS AND

methodsAn historical cohort study of 18,978 adults (43.63% female) diagnosed with type 2 diabetes before 1 April 2010 and mild NPDR before 1 April 2011 was conducted. The data were obtained from the UK Clinical Practice Research Datalink during 2010-2017, provided by 330 primary care practices in England. Exposures included attainment of the Quality and Outcomes Framework HbA1c (≤59 mmol/mol [≤7.5%]), blood pressure (≤140/80 mmHg) and cholesterol (≤5 mmol/L) indicators in the financial year 2010-2011, as well as the number of National Diabetes Audit processes completed in 2010-2011. The outcome was time to incident STDR. Nearest neighbour propensity score matching was undertaken, and univariable and multivariable Cox proportional hazards models were then fitted using the matched samples. Concordance statistics were calculated for each model.

resultsA total of 1037 (5.5%) STDR diagnoses were observed over a mean follow-up of 3.6 (SD 2.0) years. HbA1c, blood pressure and cholesterol indicator attainment were associated with lower rates of STDR (adjusted hazard ratios [95% CI] 0.64 [0.55-0.74; p < .001], 0.83 [0.72-0.94; p = .005] and 0.80 [0.66-0.96; p = .015], respectively).

conclusionsOur findings provide support for meeting appropriate indicators for the management of type 2 diabetes in primary care to bring a range of benefits, including improved health outcomes-such as a reduction in the risk of STDR-for people with type 2 diabetes.

Indexed as

Diabetes Mellitus, Type 2Diabetic RetinopathyAdultCohort StudiesEnglandFemaleHumansMalePrimary Health Caregeneral practiceNational Diabetes AuditQuality and Outcomes Frameworksight-threatening retinopathytype 2 diabetes

Identifiers

PMID33565708
PMCPMC8350793
OpenAlexW3128318125

What OpenQuestion holds

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LicenceCC BY
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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.