Evidence map›Paper›PMID 9694757›Full record

SynthesisBMJ (Clinical research ed.)1998

Diabetes care in general practice: meta-analysis of randomised control trials.

S Griffin

Open access · bronzeAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 3 pooled it
13.1field-weighted citation impact, top 1% 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

42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 198 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

1 author at 1 institution in 1 country.

S GriffinPrimary Medical Care Group, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST. SJG49@medschl.cam.ac.uk
University of Southampton · GB

Funding

Wellcome Trust
6 · The paper itself

Abstract

objectiveTo assess the effectiveness of care in general practice for people with diabetes.

designMeta-analysis of randomised trials comparing general practice and shared care with follow up in hospital outpatient clinic. IDENTIFICATION: Trials were identified from searches of eight bibliographic and research databases.

resultsFive trials identified included 1058 people with diabetes, overall mean age 58.4 years, receiving hospital outpatient follow up for their diabetes. Results were heterogeneous between trials. In shared care schemes featuring more intensive support through a computerised prompting system for general practitioners and patients, there was no difference in mortality between care in hospital and care in general practice (odds ratio 1.06, 95% confidence interval 0. 53 to 2.11); glycated haemoglobin tended to be lower in primary care (weighted difference in means of -0.28%, -0.59% to 0.03%); and losses to follow up were significantly lower in primary care (odds ratio 0.37, 0.22 to 0.61). However, schemes with less well developed support for family doctors were associated with adverse outcomes for patients.

conclusionsUnstructured care in the community is associated with poorer follow up, worse glycaemic control, and greater mortality than in hospital care. Computerised central recall, with prompting for patients and their family doctors, can achieve standards of care as good as or better than hospital outpatient care, at least in the short term. The evidence supports provision of regular prompted recall and review of selected people with diabetes by willing general practitioners. This can be achieved if suitable organisation is in place.

Indexed as

Family PracticeBlood PressureCosts and Cost AnalysisDiabetes MellitusFollow-Up StudiesHospitalizationHumansPatient Care TeamRandomized Controlled Trials as TopicReferral and Consultation

Identifiers

PMID9694757
PMCPMC28634
OpenAlexW1596043492

What OpenQuestion holds

Textmetadata
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.