Advancing current approaches to disease management evaluation: capitalizing on heterogeneity to understand what works and for whom

Elissen, Arianne MJ; Adams, John L; Spreeuwenberg, Marieke; Duimel-Peeters, Inge GP; Spreeuwenberg, Cor; Linden, Ariel; Vrijhoef, Hubertus JM

doi:10.1186/1471-2288-13-40

Table 4 Effect of active intervention features and patient characteristics on changes in HbA1c, LDL and SBP over baseline and associated changes in between-group(τ ² ) and within-group(σ ² ) variance in effects

From: Advancing current approaches to disease management evaluation: capitalizing on heterogeneity to understand what works and for whom

	HbA1c			LDL			SBP
	N	Mean difference [95% CI]	RC	N	Mean difference [95% CI]	RC	N	Mean difference [95% CI]	RC
Active intervention features
Measurement frequency			-			-*			-*
≤Median	27,322	0.09 [−0.85, 1.03]		25,420	−0.08* [−0.12, -0.05]		21,764	−0.99* [−1.57, -0.41]
>Median	20,913	−0.06 [−1.47, 1.36]		10,782	−0.20* [−0.26, -0.15]		25,824	−1.01* [−1.38, -0.64]
Measurement range			-*			-			+*
<8 outcomes	15,641	0.13 [−1.08, 1.34]		6500	−0.10* [−0.15, -0.05]		14,397	−1.60* [−2.02, -1.17]
8 outcomes	51,820	0.05 [−0.66, 0.75]		45,301	−0.10* [−0.14, -0.06]		50,392	−0.79* [−1.15, -0.43]
Length of follow-up			+*			+*			+*
≤1 year	57,069	0.02 [−0.77, 0.81]		43,901	−0.09* [−0.13, -0.05]		55,686	−1.27* [−1.60, -0.95]
>1 year	18,058	0.53 [−0.22, 1.27]		14,796	−0.11* [−0.15, -0.06]		17,751	−0.04 [−0.52, 0.44]
Change in τ ²		26.0%			−37.0%			15.6%
Change in σ ²		−0.1%			0.7%			5.2%
Patient characteristics
Age			-*			+*			+*
≤59	20,538	0.21 [−0.56, 0.98]		15,857	−0.12* [−0.16, -0.07]		20,139	−0.57* [−0.92, -0.23]
60-69	24,204	0.23 [−0.55, 1.02]		19,364	−0.09* [−0.13, -0.05]		23,689	−1.00* [−1.38, -0.62]
≥70	30,382	0.03 [−0.78, 0.83]		23,474	−0.08* [−0.12, -0.03]		29,605	−1.34* [−1.72, -0.96]
Disease duration			+*			-			+
≤2	21,261	-0.12 [−1.12, 0.88]		16,756	−0.14* [−0.19, -0.08]		21,673	−1.04* [−1.47, -0.62]
3-5	13,342	0.11 [−0.76, 0.98]		10,607	−0.08* [−0.12, -0.03]		13,117	−0.55* [−0.97, -0.13]
≥6	20,474	−0.07 [−1.08, 0.95]		15,857	−0.06* [−0.10, -0.01]		19,645	−1.22* [−1.61, -0.84]
Baseline health			-*			-*			-*
Good	51,545	1.79* [1.17, 2.41]		29,311	0.15* [0.12, 0.18]		42,784	4.59 [4.21, 4.97]
Moderate	21,637	−2.62* [−3.46, -1.78]		19,984	−0.17* [−0.20, -0.14]
Poor	1945	−16.82* [−18.7,-15.0]		9402	−0.72* [−0.77, -0.67]		30,653	−8.91 [−9.67, -8.16]
Diabetes complications			+*			-*			-*
No	53,065	0.04 [−0.63, 0.71]		39,721	−0.10* [−0.14, -0.06]		50,780	−0.93* [−1.29, -0.58]
Yes	10,183	−0.06 [−0.76, 0.65]		7994	−0.08* [−0.15, -0.01]		9788	−1.25* [−1.75, -0.75]
Smoking status			+*			-			-
No/previously	46,277	0.23 [−0.28, 0.73]		38,294	−0.09* [−0.13, -0.04]		46,908	−0.90* [−1.24, -0.56]
Yes	10,375	0.20 [−0.85, 1.25]		7762	−0.11* [−0.15, -0.06]		10,504	−1.07* [−1.54, -0.59]
Change in τ ²		−12.5%			−33.9%			74.8%
Change in σ ²		−23.5%			−21.7%			−29.9%

NOTE: N indicates number of patients, CI, confidence interval, RC, regression coefficient, +, positive regression slope, -, negative regression slope, *statistically significant (p < 0.05), baseline health status is defined according to the target values of the national diabetes care standard: Good (HbA1c ≤ 53 mmol/mol, LDL < 2.5 mmol/l, SBP ≤ 140 mmHg), Moderate (HbA1c 54-74 mmol/mol, LDL 2.5-3.5 mmol/l), Poor (HbA1c ≥ 75 mmol/mol, LDL > 3.5 mmol/l, SBP > 140 mmHg).

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ISSN: 1471-2288

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