Targeted case finding in the prevention of cardiovascular disease: a stepped wedge cluster randomised controlled trial

Hemming, Karla; Ryan, Ronan; Gill, Paramjit; Westerby, Paul; Jolly, Kate; Marshall, Tom

doi:10.3399/bjgp16x686629

Cited by 15 publications

(25 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Example 1 (Time adjusted treatment effect) —“A total of 321 (10.8%) unexposed patients were started on either antihypertensives or statins, and 577 (19.7%) exposed patients. The time-adjusted mean difference in proportion of patients initiating either treatment was 15.5% (95% confidence interval, 3.9 to 27.1).” 52 …”

Section: Results: Outcomes and Estimationmentioning

confidence: 99%

“…Example 3 (Correlations) —“The ICC in the time-adjusted analysis for initiation of either treatment was 0.014 (95% confidence interval, 0.005 to 0.038).” 52 …”

Section: Results: Outcomes and Estimationmentioning

confidence: 99%

“…Example 2 (Sample size fixed by design) —“The study had a fixed sample size by design that could not be modified, so the power calculations did not inform any sample size targets.” 52 …”

Section: Methods: Sample Sizementioning

confidence: 99%

See 2 more Smart Citations

Reporting of stepped wedge cluster randomised trials: extension of the CONSORT 2010 statement with explanation and elaboration

Hemming

Taljaard

McKenzie

et al. 2018

BMJ

Self Cite

293

316

View full text Add to dashboard Cite

This report presents the Consolidated Standards of Reporting Trials (CONSORT) extension for the stepped wedge cluster randomised trial (SW-CRT). The SW-CRT involves randomisation of clusters to different sequences that dictate the order (or timing) at which each cluster will switch to the intervention condition. The statement was developed to allow for the unique characteristics of this increasingly used study design. The guideline was developed using a Delphi survey and consensus meeting; and is informed by the CONSORT statements for individual and cluster randomised trials. Reporting items along with explanations and examples are provided. We include a glossary of terms, and explore the key properties of the SW-CRT which require special consideration in their reporting.

show abstract

Section: Results: Outcomes and Estimationmentioning

confidence: 99%

“…Example 3 (Correlations) —“The ICC in the time-adjusted analysis for initiation of either treatment was 0.014 (95% confidence interval, 0.005 to 0.038).” 52 …”

Section: Results: Outcomes and Estimationmentioning

confidence: 99%

See 1 more Smart Citation

Reporting of stepped wedge cluster randomised trials: extension of the CONSORT 2010 statement with explanation and elaboration

Hemming

Taljaard

McKenzie

et al. 2018

BMJ

Self Cite

293

316

View full text Add to dashboard Cite

show abstract

“… 35 A randomised trial of a multifaceted intervention was not effective 34 and another randomised trial of targeted nurse-led case finding found an increase in blood pressure measurement, although the improvement in starting patients on antihypertensive treatment just failed to reach statistical significance. 36 …”

Section: Resultsmentioning

confidence: 99%

Levels of detection of hypertension in primary medical care and interventions to improve detection: a systematic review of the evidence since 2000

et al. 2018

View full text Add to dashboard Cite

ObjectivesIn England, many hypertensives are not detected by primary medical care. Higher detection is associated with lower premature mortality. We aimed to summarise recent evidence on detection and interventions to improve detection in order to inform policies to improve care.DesignData sources: systematic review of articles published since 2000. Searches of Medline and Embase were undertaken. Eligibility criteria: published in English, any study design, the setting was general practice and studies included patients aged 18 or over. Exclusion criteria: screening schemes, studies in primary care settings other than general practice, discussion or comment pieces. Participants: adult patients of primary medical care services. Synthesis: study heterogeneity precluded a statistical synthesis, and papers were described in summary tables.ResultsSeventeen quantitative and one qualitative studies were included. Detection rates varied by gender and ethnic group, but longitudinal studies indicated an improvement in detection over time. Patient socioeconomic factors did not influence detection, but living alone was associated with lower detection. Few health system factors were associated with detection, but in two studies higher numbers of general practitioners per 1000 population were associated with higher detection. Three studies investigated interventions to improve detection, but none showed evidence of effectiveness.LimitationsThe search was limited to studies published from 2000, in English. There were few studies of interventions to improve detection, and a meta-analysis was not possible.Conclusions and implicationsLevels of detection of hypertension by general practices may be improving, but large numbers of people with hypertension remain undetected. Improvement in detection is therefore required, but guidance for primary medical care is not provided by the few studies of interventions included in this review. Primary care teams should continue to use low-cost, practical approaches to detecting hypertension until evidence from new studies of interventions to improve detection is available.

show abstract

“…The service can be framed as a type of epidemiological clinic—the identification of people “at risk” is through objective measures (the Framingham Risk Score which is a gender‐specific algorithm used to estimate the 10‐year cardiovascular risk of an individual) rather than subjective individualised care. Case finding was used on the basis of primary care records to identify people potentially at high risk (Hemming et al, ; Marshall et al, ). They were then invited for further risk assessment either by a specialist cardiovascular nurse or by the health trainer.…”

Section: Methodsmentioning

confidence: 99%

Co‐production in the epidemiological clinic: A decentred analysis of the tensions in community‐based, client‐facing risk work

2018

View full text Add to dashboard Cite

Public health policies to prevent disease within populations are giving rise to shifting patterns of healthcare delivery in the late modern era. There is an inherent tension in modern medicine between evidence-based standardisation, on the one hand, and patient-centred specificity on the other. This tension manifests in recent policy narratives regarding public health risk (which we have characterised in terms of the epidemiological clinic) and co-production. Drawing on coproduced data with health trainers (lay health workers /journal/spol 203 attempt to reconcile this context with the risk-framed practices they are required to carry out.

show abstract

Targeted case finding in the prevention of cardiovascular disease: a stepped wedge cluster randomised controlled trial

Abstract: Targeted case finding in the prevention of cardiovascular disease: a stepped wedge cluster randomised controlled trial

Cited by 15 publications

References 30 publications

Reporting of stepped wedge cluster randomised trials: extension of the CONSORT 2010 statement with explanation and elaboration

Reporting of stepped wedge cluster randomised trials: extension of the CONSORT 2010 statement with explanation and elaboration

Levels of detection of hypertension in primary medical care and interventions to improve detection: a systematic review of the evidence since 2000

Co‐production in the epidemiological clinic: A decentred analysis of the tensions in community‐based, client‐facing risk work

Contact Info

Product

Resources

About