Evidence map›Paper›PMID 39966713›Full record

SynthesisBMC primary care2025

The involvement of specialists in primary healthcare teams for managing diabetes: a systematic review and meta-analysis.

Jia Li, Zhihan Xu, Huilan Zhou, Zhansheng Li, Beibei Yuan

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC primary care, 2025. 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
–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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. 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

5 authors.

Jia LiDepartment of Health Policy and Management, School of Public Health, Peking University, Beijing, China.
Zhihan XuChinese Center for Disease Control and Prevention, Beijing, China.
Huilan ZhouSchool of Public Health, Sun Yat-sen University, Guangzhou, China.
Zhansheng LiHealth Commission of Weifang, Weifang, Shandong Province, China.
Beibei YuanCenter for Health Development Studies, Peking University, Beijing, China. beibeiyuan@bjmu.edu.cn.

Funding

China National Nature Science Fund 72274006
6 · The paper itself

Abstract

backgroundDiabetes mellitus requires ongoing management and care coordination. The majority of patients with diabetes were managed in primary healthcare settings. Several quality improvement programs have introduced specialist involvement in primary healthcare teams. However, synthesized evidence is needed to support policy improvements regarding the impact of specialist-primary healthcare coordination on glycemic control in diabetes care.

objectiveThis systematic review and meta-analysis aimed to assess the effectiveness of specialist involvement in primary healthcare teams on glycemic control of patients with diabetes.

methodsA search of five electronic databases (PubMed, Embase, Web of Science Core Collection, CNKI, and Wanfang Database) was conducted to identify relevant studies published until October 21st, 2023. We assessed the methodological quality of the included studies using the suggested risk of bias criteria for EPOC (Cochrane Effective Practice and Organization of Care). We conducted the certainty assessment using the GRADE guideline. The outcome measured was the HbA1c level. Meta-analyses were performed using random-effects models.

resultsA total of 12 studies (7 randomized controlled trials and 5 controlled before-after studies) were included in the meta-analysis. The involvement of specialists in primary healthcare teams was associated with a statistically significant reduction in HbA1c level compared to usual or standard care (mean difference - 0.57, 95% CI: -0.86 to -0.27, I

conclusionThe findings revealed that the interventions might improve the care delivered and patients' health outcomes. However, due to the very low certainty of evidence on the effectiveness on glycemic control, the interventions implemented in the included studies should be employed with caution in future policy-making to achieve improved HbA1c levels. Further research with a more rigorous design is needed to provide evidence of higher certainty and quality. REGISTRATION: The systematic review and meta-analysis was registered in the PROSPERO International Prospective Register of Systematic Reviews (registration No. CRD42022384589 available at https://www.crd.york.ac.uk/prospero/#searchadvanced ).

Indexed as

Diabetes MellitusPatient Care TeamPrimary Health CareSpecializationGlycated HemoglobinHumansGlycated HemoglobinDiabetes mellitusHbA1cMeta-analysisPrimary healthcareSpecialistsSystematic review

Identifiers

PMID39966713
PMCPMC11837382

What OpenQuestion holds

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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.