Evidence map›Paper›PMID 39473047›Full record

ArticleDiabetic medicine : a journal of the British Diabetic Association2025

An audit and feedback-based intervention to improve diabetes management in the year after transfer to adult type 1 diabetes care: A multi-center quasi-experimental study.

Rayzel Shulman, Ian Zenlea, Noah Ivers, Peter C Austin, Ping Li, Cheril Clarson, Alanna Landry, Jennifer Harrington, Geetha Mukerji, Mark R Palmert and 3 more

Abstract readMulticenter Study
In one paragraph

Article in Diabetic medicine : a journal of the British Diabetic Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

13 authors.

Rayzel ShulmanDivision of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0001-9943-1529
Ian ZenleaDepartment of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
Noah IversInstitute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Peter C AustinICES, Toronto, Ontario, Canada.
Ping LiICES, Toronto, Ontario, Canada.
Cheril ClarsonChildren's Hospital, London Health Sciences Centre, London, Ontario, Canada.
Alanna LandryOak Valley Health, Markham Stouffville Hospital, Markham, Ontario, Canada.
Jennifer HarringtonDivision of Endocrinology, Women's and Children's Health Network, University of Adelaide, Adelaide, South Australia, Australia.
Geetha MukerjiDivision of Endocrinology, Women's College Hospital, Toronto, Ontario, Canada.
Mark R PalmertDivision of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Janet ParsonsDepartment of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Zubin PunthakeeDepartment of Medicine and Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Baiju R ShahICES, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0003-3598-3628

Funding

CIHR
6 · The paper itself

Abstract

aimTo test whether an audit and feedback-based intervention improved HbA1c 12 months after transfer to type 1 diabetes adult care.

methodsMulti-centre, quasi-experimental pre-post study of an AF-based intervention targeting paediatric diabetes teams, which encouraged the implementation of an evidence-informed structured transition process at five paediatric diabetes centres in Ontario, Canada. Participants entered the study at their final paediatric visit. A parallel control cohort was ascertained using population-based administrative datasets. The primary outcome was HbA1c 12 months after transfer. The main exposure was the study period: pre-implementation (June 2018-May 2019); early-implementation (June 2019-September 2020); and late-implementation (October 2020-September 2021). Multivariable linear regression models were fit separately in each cohort.

resultsThere were 449 and 2844 individuals in the intervention and control cohorts, respectively. Twelve months after transfer, participants in the late-implementation intervention cohort had an HbA1c that was, on average, 0.41% lower than participants in the pre-implementation period (p = 0.016). Among the control cohort, there was no significant difference in the HbA1c 12 months after transfer between study periods.

conclusionsWe found an effect of the intervention on glycaemic management one year following transfer to adult care. Future work will focus on refining and testing the effectiveness of the intervention in an expanded number of study sites and in collaboration with adult diabetes care providers.

Indexed as

Diabetes Mellitus, Type 1Glycated HemoglobinTransition to Adult CareAdolescentAdultFeedbackFemaleGlycemic ControlHumansMaleMedical AuditOntarioQuality ImprovementYoung AdultGlycated Hemoglobinhemoglobin A1c protein, humanadolescenthealth services researchquality improvementtransition to adult caretype 1 diabetes mellitusyoung adult

Identifiers

PMID39473047
PMCPMC11635587

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LicenceCC BY-NC-ND
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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.