Evidence map›Paper›PMID 35365186›Full record

ReviewTrials2022

Pragmatic trials can address diagnostic controversies: recent lessons from gestational diabetes.

Jean Raymond, Hélène Long, Tim Darsaut

Open access · goldAbstract readLetterReview
In one paragraph

Review in Trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.4field-weighted citation impact, top 40% 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

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

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

3 authors at 3 institutions in 1 country.

Jean RaymondDepartment of Radiology, Service of Interventional Neuroradiology, Centre Hospitalier de l'Université de Montréal (CHUM), University of Montreal, Montreal, Quebec, H2X 0C1, Canada. jean.raymond@umontreal.ca.ORCID http://orcid.org/0000-0003-1978-4274
Hélène LongDepartment of Medicine, Division of Endocrinology and Metabolism, Laval Health and Social Services Centres, Laval, Canada.
Tim DarsautDivision of Neurosurgery, Department of Surgery, University of Alberta Hospital, Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada.
Centre Hospitalier de l’Université de Montréal · CACentre Integre de Sante et de Services Sociaux de Laval · CAHealth Sciences Centre · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of the paper is to discuss how a pragmatic definition could change our conception of diagnosis, using gestational diabetes mellitus (GDM) as an example. STUDY

designWe review the diagnostic controversy that followed an observational study showing a linear relationship between maternal glycaemia and adverse pregnancy outcomes and the resolution proposed 15 years later by a recent pragmatic trial comparing two screening approaches (one- vs two-step) with different diagnostic thresholds.

resultsThe pragmatic trial involved approximately 24,000 women. The one-step screening strategy using lower GDM thresholds diagnosed twice as many women with GDM, but pregnancy outcomes were not different. We examine how the pragmatic approach integrates research into practice and defines the meaning of a diagnosis according to patient outcomes. The approach is ethically and scientifically sound as compared to the previous methodology, where observational research separated from care gave a theoretical definition of GDM that may have misled medical practice for two decades.

conclusionPragmatic research integrated into practice can revolutionize our conception of medical diagnosis in the best medical interest of patients.

Indexed as

Diabetes, GestationalBlood GlucoseFemaleHumansMass ScreeningObservational Studies as TopicPregnancyPregnancy OutcomeBlood GlucoseDiagnostic studiesGestational diabetesPragmatic clinical trialsResearch ethics

Identifiers

PMID35365186
PMCPMC8973943
OpenAlexW4220801071

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.