Evidence map›Paper›PMID 39990899›Full record

ArticleKidney international reports2025

Cost-Effectiveness of Clinical Decision Support to Improve CKD Outcomes Among First Nations Australians.

Winnie Chen, Kirsten Howard, Gillian Gorham, Asanga Abeyaratne, Yuejen Zhao, Oyelola Adegboye, Nadarajah Kangaharan, Sean Taylor, Louise J Maple-Brown, Samuel Heard and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Kidney international reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Guideline
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

15 authors.

Winnie ChenMenzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Kirsten HowardLeeder Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.
Gillian GorhamMenzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Asanga AbeyaratneMenzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Yuejen ZhaoNorthern Territory Health, Darwin, Northern Territory, Australia.
Oyelola AdegboyeMenzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Nadarajah KangaharanDivision of Medicine, Northern Territory Health, Darwin, Northern Territory, Australia.
Sean TaylorMenzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Louise J Maple-BrownMenzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Samuel HeardCentral Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia.
Mohammad Radwanur TalukderMenzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Abdolvahab BaghbanianCentral Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia.
Sandawana William MajoniDepartment of Nephrology, Division of Medicine, Royal Darwin Hospital, Northern Territory Health, Darwin, Northern Territory, Australia.
Alan CassMenzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.
Territory Kidney Care Steering Committee

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The Northern Territory (NT) is a hotspot for chronic kidney disease (CKD) and has a high incidence of kidney replacement therapy (KRT). The Territory Kidney Care clinical decision support (CDS) tool aims to improve diagnosis and management of CKD in remote NT, particularly among First Nations Australians. We model the cost-effectiveness of the CDS versus usual care. Methods: Taking a health care funder perspective, we modeled a cohort of people from remote NT at risk of or with CKD, as of January 1, 2017. A Markov cohort model was developed using 6 years of observed patient-level data (2017-2023), extrapolated to a 15-year time horizon. The CDS tool was modeled to improve CKD diagnosis (scenario 1), improve management (scenario 2), or improve both diagnosis and management (scenario 3). Results: The remote NT cohort consisted of 23,195 people, predominantly (89%) First Nations, with a mean age of 42 years. Scenario 3 (improved diagnosis and management) was most cost-effective at an incremental cost-effectiveness ratio (ICER) of $96,684 per patient avoiding KRT, $30,086 per patient avoiding death. Scenario 1 (improved diagnosis) was less cost-effective, and scenario 2 (improved management) was the least cost-effective. The ICER per quality-adjusted life years (QALYs) gained ranged from $3427 (scenario 3) to $63,486 (scenario 2). Conclusion: Territory Kidney Care is highly cost-effective when it supports early diagnosis of CKD and increases optimal management in diagnosed patients. These results support investing in CDS tools, implemented in strong partnerships, to improve outcomes in settings with a high burden of CKD.

Indexed as

Aboriginal healthchronic kidney diseaseclinical decision supportcostcost-effectivenesseconomic evaluationFirst Nationshealth economicshealth informatics

Identifiers

PMID39990899
PMCPMC11843118

What OpenQuestion holds

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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.