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Trial procedures | atrial fibrillation, peripheral artery disease stroke, venous thromboembolism | MYOCARDIAL INFARCTION, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, ATRIAL FIBRILLATION, APPENDIX, CORONARY ARTERY DISEASE | At the dedicated study center, patients received a highly standardized 5-h clinical and medical technical examination from October 2016 to June 2020. Trained and certified medical assistants performed all procedures according to standard operating procedures. Comprehensive phenotyping was performed identically at visit... | PMC10293456 |
Study endpoints | The primary endpoint of the EmDia trial was defined as the change of | PMC10293456 | ||
Statistical analysis | obesity, congestive heart failure | REGRESSION, OBESITY, CONGESTIVE HEART FAILURE, LEFT VENTRICULAR HYPERTROPHY | All randomized subjects who received at least one dose of trial treatment and had at least one available post-baseline assessment of the primary analysis variable were included in the intention-to-treat (ITT) population (primary analysis sample). Continuous variables are presented by mean and standard deviation for nor... | PMC10293456 |
Results | PMC10293456 | |||
Effect of empagliflozin compared to placebo on left ventricular diastolic function | The Pre-specified analysis of the effect of empagliflozin 10 mg/day versus placebo on the primary study endpoint Analysis of the short-term effect of empagliflozin on diastolic function after 1 week of intervention indicated a decrease in | PMC10293456 | ||
Sensitivity and mediation analyses for the change in left ventricular diastolic function | In a next step, sensitivity analysis in clinically relevant subgroups has been carried out (Fig. Effect of empagliflozin 10 mg/day vs. placebo on the primary study endpoint after 12 weeks of intervention in clinically-relevant subgroups. Beta-estimates for the effect of empagliflozin 10 mg/day compared to placebo on To... | PMC10293456 | ||
Discussion | heart failure, diastolic dysfunction, diabetes mellitus | DIASTOLIC DYSFUNCTION, DIABETES MELLITUS, SECONDARY, HEART FAILURE, TYPE 2 DIABETES MELLITUS | The present study investigated the effects of the SGLT2 inhibitor empagliflozin in patients with diastolic dysfunction and type 2 diabetes mellitus. The results indicate a significant improvement in diastolic function as measured by left ventricular The results of the EmDia trial add to the growing body of evidence sup... | PMC10293456 |
Strengths and limitations | left ventricular | The major strength of the present study is the well-phenotyped cohort, which was studied in a dedicated study center by trained staff in a highly standardized setting minimizing variability of data assessment at high accuracy and reproducibility. However, several limitations should be noted when interpreting the study ... | PMC10293456 | |
Conclusions | heart failure, type 2 diabetes mellitus | HEART FAILURE, TYPE 2 DIABETES MELLITUS | The results of the present EmDia trial demonstrated that empagliflozin 10 mg/day improved diastolic function in patients with type 2 diabetes mellitus and elevated left ventricular end-diastolic pressure within 12 weeks of treatment. The beneficial effect of empagliflozin was consistent across all subgroups and also oc... | PMC10293456 |
Supplementary Information | Below is the link to the electronic supplementary material.Supplementary file1 (DOCX 144 KB) | PMC10293456 | ||
Acknowledgements | We would like to thank all study participants of the EmDia trial for their participation in this clinical study. Our thanks go to the clinical staff of the study center, the Interdisciplinary Center for Clinical Trials Mainz (IZKS) for trial support (i.e., Dr. Kai Kronfeld, Dr. Silke Warnke, Christoph Medler, Dr. Jana ... | PMC10293456 | ||
Author contributions | TG, SJS, FM | JHP contributed to study design, collection of data, data analysis, and drafted and revised the manuscript. CJ contributed to study design, supported data analysis and revised the manuscript for important intellectual content. AS contributed to study design, performed statistical analysis, contributed to the interpreta... | PMC10293456 | |
Funding | Open Access funding enabled and organized by Projekt DEAL. The EmDia trial is an academic, GCP sponsor-investigator clinical trial funded with support of Boehringer Ingelheim. Dr. Wild and Dr. Prochaska are funded by the Federal Ministry of Education and Research (BMBF 01EO1503). Dr. Gori, Dr. Münzel and Dr. Wild are p... | PMC10293456 | ||
Data availability | This project constitutes a major scientific effort with high methodological standards and detailed guidelines for analysis and publication. Data are not made available for the scientific community outside the established and controlled workflows and algorithms. To meet the general idea of verification and reproducibili... | PMC10293456 | ||
Declarations | PMC10293456 | |||
Conflict of interest | MyoKardia | EDWARDS | Dr. Prochaska has received honoraria for lectures from Boehringer Ingelheim and Bayer AG outside the topic of the present study. Dr. Wild has received research funding outside the topic of the present study from Boehringer Ingelheim, Sanofi-Aventis, Bayer Healthcare, Daiichi Sankyo Europe, and Novartis, and received ou... | PMC10293456 |
Collaborators of the study | Thomas | Dr. Jürgen H. Prochaska, Dr. Andreas Schulz, Dr. Natalie Arnold, Dr. Felix Müller, Dr. Marc William Heidorn, Rieke Baumkötter, Dr. Daniela Zahn, Dr. Thomas Koeck, Dr. Sven-Oliver Tröbs, Dr. Karl J. Lackner, Dr. Andreas Daiber, Dr. Harald Binder, Dr. Sanjiv J. Shah, Dr. Tommaso Gori, Dr. Thomas Münzel, Dr. Philipp S. Wi... | PMC10293456 | |
References | PMC10293456 | |||
Subject terms | Women have less influence than men in a variety of settings. Does this result from stereotypes that depict women as less capable, or biased interpretations of gender differences in behavior? We present a field experiment that—unbeknownst to the participants—randomized the gender of avatars assigned to Democrats using a... | PMC10462641 | ||
Introduction | female-typed behaviors, incongruity, male-typed behaviors | Women have less influence than men in a variety of decision-making settings such as businessIn this article, we ask: What causes women’s lower influence in discussions about politics, and how might it be improved? Previous research indicates gender gaps emerge in social contexts where people already have expectations o... | PMC10462641 | |
Experimental design | APPENDIX | We conducted a field experiment during the 2020 U.S. Democratic presidential primary election on a text-based social media platform designed for academic research,(see Fig.
Research design. In the control condition, one man talks to one woman, and both discussants are represented by an avatar associated with their sel... | PMC10462641 | |
Results | We report our results using four types of outcomes. First, we compare the gender gap in the level of influence of each partner in a cross-gender conversation. The gap is evaluated using three metrics, and their composite index: (1) the partner’s subjective survey report of the subject’s influence on their attitudes, (2... | PMC10462641 | ||
Influence gap | POSITIVE | Figure Effects of gender mislabeling on the influence gap in cross-gender conversations about the 2020 Democratic Primary Election. The influence gap measures the difference between the influence of the man and woman on the given measure. Positive values indicate that the man is more influential. Dots are point estimat... | PMC10462641 | |
Attitude convergence | To further explore the consequences of the mislabeling intervention for the overall trajectory of conversations, we examine a conversation-level metric of convergence in thermometer rankings across all candidates. We compare the average gap between the subject’s rating of each candidate and their partner’s rating of th... | PMC10462641 | ||
Individual-level influence metrics | Because a conversation is a dynamic interaction between two people, the change in the influence gap metrics might come from two mechanisms—a change in the persuasiveness of one partner, or a change in the other partner’s propensity to be influenced. In order to distinguish these two mechanisms, we evaluate the treatmen... | PMC10462641 | ||
Language choice | Thus far, we have provided evidence consistent with a theory that both gender stereotypes and gender performance interact to produce gender inequality in interpersonal influence, but that neither gender stereotypes nor gendered performance are a dominant mechanism for that effect. We next turn to a direct evaluation of... | PMC10462641 | ||
Discussion | incongruity | Gender gaps in interpersonal influence are far more complex than many theories account for. Using a field experiment on an anonymous chat platform created to simulate social media conversations during the 2020 presidential primaries, we randomized people to talk with partners of different genders while being represente... | PMC10462641 | |
Methods | RECRUITMENT, APPENDIX | We hired the survey firm YouGov to recruit self-identified Democrats who were told they had been randomly selected for an opportunity to earn $10 for testing a new app. Recruitment started on February 28, 2020, and the app, called UniteDem, was described as a way for Democrats to anonymously discuss which candidate was... | PMC10462641 | |
Supplementary Information | The online version contains supplementary material available at 10.1038/s41598-023-39359-0. | PMC10462641 | ||
Acknowledgements | BROWN | The authors are grateful to Jessica Preece, Chris Karpowitz, Lynn Smith-Lovin, Diana O’Brien, Craig Rawlings, Ashley Harrell, Taylor Brown, members of the Workshop on American Politics at the University of North Carolina Chapel Hill, the PoNE Lab Workshop at Aarhus University, and the BYU Thursday Group for comments an... | PMC10462641 | |
Author contributions | Conceptualization: A.C., G.T., F.A., D.C., G.V., C.B., A.V. Methodology: A.C., G.T., F.A., D.C., G.V., C.B., A.V. Software: A.C. Investigation: A.C., G.T., F.A., D.C., G.V., C.B., A.V. Formal analysis: A.C., G.T., F.A., A.C.A., L.A., A.V. Writing—Original Draft: A.C., G.T., F.A., A.C.A., L.A., C.B. Writing—Review and E... | PMC10462641 | ||
Funding | Funding for this project was generously provided by the Duke University Provost and the National Science Foundation (DMS-2046880). | PMC10462641 | ||
Data availability | Anonymized replication code and data are available at this link: | PMC10462641 | ||
Code availability | Upon publication, replication code will be made publicly available by the authors at this link: | PMC10462641 | ||
Competing interests | The authors declare no competing interests. | PMC10462641 | ||
References | PMC10462641 | |||
Context | PATHOPHYSIOLOGY | Edited by: Roberta Minelli, University Hospital of Parma, ItalyReviewed by: Matteo Spaziani, Division of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Italy; Joanne Rovet, University of Toronto, Canada†ORCID: Divya M. Mathews, This article was submitted to Pediatric Endocrinology... | PMC9927197 | |
Objective | thyroid dysfunction | THYROID DYSFUNCTION | To determine the incidence of thyroid dysfunction in newborns conceived within six months of OSCM HSG. | PMC9927197 |
Design | Offspring study of a prospective cohort of women who underwent OSCM HSG. | PMC9927197 | ||
Setting | Auckland region, New Zealand (2020-2022) | PMC9927197 | ||
Participants | Offspring from the SELFI (Safety and Efficacy of Lipiodol in Fertility Investigations) study cohort (n=57). | PMC9927197 | ||
Measurements | All newborns had a dried blood spot card for TSH measurement 48 hours after birth as part of New Zealand’s Newborn Metabolic Screening Programme. Forty-one neonates also had a heel prick serum sample at one week to measure thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3). Materna... | PMC9927197 | ||
Primary outcome | hypothyroidism | HYPOTHYROIDISM | Incidence of hypothyroidism in the neonatal period. | PMC9927197 |
Results | primary hypothyroidism | PRIMARY HYPOTHYROIDISM | There was no evidence of primary hypothyroidism on newborn screening (TSH 2-10 mIU/L). All neonates tested at one week had normal serum TSH, FT4, and FT3 levels. However, increasing maternal peak UIC levels during pregnancy were associated with lower TSH levels (p= 0.006), although also associated with lower FT4 levels... | PMC9927197 |
Conclusions | NEONATAL HYPOTHYROIDISM | While pre-conceptional OSCM HSG in women did not result in neonatal hypothyroidism, gestational iodine excess was associated with a paradoxical lowering of neonatal TSH levels despite lower FT4 levels. These changes likely reflect alterations in deiodinase activity in the fetal hypothalamic-pituitary axis from iodine e... | PMC9927197 | |
Introduction | PRIMARY HYPOTHYROIDISM | Oil-soluble contrast medium (OSCM) hysterosalpingography (HSG) improves pregnancy rates in women under 40 years of age (As OSCM HSG is becoming increasingly popular as a fertility-enhancing procedure, it is essential to establish its potential effects on neonatal thyroid function. Previous studies examining thyroid fun... | PMC9927197 | |
Aims and objectives | CONGENITAL HYPOTHYROIDISM, SUBCLINICAL HYPOTHYROIDISM | This study aimed to prospectively determine the thyroid function status of the newborns conceived following OSCM HSG, and establish whether there were any associations between maternal iodine or thyroid hormone levels following the HSG and neonatal thyroid function. The objectives were to determine the incidence of:Sub... | PMC9927197 | |
Materials and methods | thyroid dysfunction, hypothyroidism | THYROID DYSFUNCTION, HYPOTHYROIDISM, HYPERTHYROIDISM, RECRUITMENT | Participants were the offspring of the Safety and Efficacy of Lipiodol in Fertility Investigations (SELFI) study, conducted in Auckland. The study was approved by the Northern B Health and Disability Ethics Committee (Ministry of Health; 19/NTB/52) and registered with the Australian New Zealand Clinical Trials Registry... | PMC9927197 |
Statistical analyses | Pearson’s correlation coefficients (Additional general linear models were run for all offspring outcomes, including both maternal predictors (i.e., peak UIC and TSH levels) and their interaction term. If the latter was statistically significant, the interaction between the two predictors and a given outcome was illustr... | PMC9927197 | ||
Results | NVD | THYROID | All 57 newborns were screened by the national programme, but 16 parents declined the thyroid function tests on their babies at day 7 (Demographic and clinical characteristics of the offspring born in the SELFI study who were screened under the New Zealand newborn metabolic screening programme and those who also had a t... | PMC9927197 |
Discussion | hypothyroidism, asphyxia, congenital hypothyroidism, prematurity, primary hypothyroidism, infertility, primary thyroid dysfunction, sepsis | HYPOTHYROIDISM, ASPHYXIA, CONGENITAL HYPOTHYROIDISM, PRIMARY HYPOTHYROIDISM, COMPLICATION, SYNDROME, SEPSIS, SUBCLINICAL HYPOTHYROIDISM, PERMANENT CONGENITAL HYPOTHYROIDISM | This prospective offspring cohort study examined neonatal screening TSH data of 57 newborns whose mothers received pre-conceptional OSCM HSG, finding no cases of transient subclinical hypothyroidism or permanent congenital hypothyroidism. This is reassuring and is consistent with studies from China (The only study that... | PMC9927197 |
Conclusions | primary hypothyroidism | PRIMARY HYPOTHYROIDISM | This study confirms there is no increase in neonatal primary hypothyroidism in the offspring conceived following a standard OSCM HSG procedure. However, subtle central dysregulation of thyroid function may have occurred in some of these offspring. Future studies should be directed to assess the persistence of these cha... | PMC9927197 |
Data availability statement | The raw data supporting the conclusions of this article are not publicly available, but are available from the corresponding author on reasonable request and following the appropriate ethics approval. | PMC9927197 | ||
Ethics statement | The study was approved by the Northern B Health and Disability Ethics Committee, New Zealand (Ministry of Health; 19/NTB/52). Written informed consent to participate in this study was provided by the participants’ legal guardian/next of kin. | PMC9927197 | ||
Author contributions | RS, DM | PH, NJ, JP, RS, and SO’S conceptualized the study; DM conducted the study and drafted the initial manuscript; NH and DW assisted with newborn data collection, which were analysed by JD, DM, and PH. All authors contributed to the article and approved the submitted version. | PMC9927197 | |
Acknowledgments | We would like to acknowledge Guerbet for the research grant to the Liggins Institute. We also thank Janene McMillan (University of Auckland) for her invaluable help organizing the newborn investigations, and Alice Wang (University of Auckland) for managing the SELFI accounts. | PMC9927197 | ||
Conflict of interest | RS, JP | NJ is involved in research with the University of Auckland and the University of Adelaide, which are funded by Guerbet; NJ has undertaken paid consultancies for Guerbet; DM and PH are involved with a University of Auckland study on Lipiodol safety through an unrestricted independent grant to the Liggins institute from ... | PMC9927197 | |
Publisher’s note | All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or ... | PMC9927197 | ||
Supplementary material | The Supplementary Material for this article can be found online at: Click here for additional data file. | PMC9927197 | ||
References | PMC9927197 | |||
2. Materials and Methods | This study deployed a between-subject longitudinal design to examine the effects of eccentric-oriented vs. traditional strength training protocols on crucial return-to-sport performance outcomes in professional team sport players during the late-stage ACL rehabilitation phase. | PMC10305302 | ||
2.1. Subjects | chondral defects, first-division | The sample for this study was selected out of 134 ACL patients who underwent rehabilitation in a rehab-specialized fitness facility (the Center of Excellence in Sport Science, Novi Sad, Serbia) between January 1, 2018, and December 31, 2022. In order to be selected for this study, subjects had to be professional team s... | PMC10305302 | |
2.2. Study Design | inflammation, swelling | INFLAMMATION | All participants were engaged in a standard rehabilitation program and supervised by two highly skilled practitioners (MSc and PhD in Sport Science with more than 10 years of experience and 200 ACL rehabilitations) until enrolled in the study (During the early stage of rehab (around 12 weeks), care was taken to decreas... | PMC10305302 |
2.3. Rehabilitation Protocols | CONTRACTIONS | The training period was 6 weeks long, with training occurring 6 days per week for participants in both groups. As a core of the rehabilitation protocol, two to three strength training sessions were conducted per week (15 training sessions in total), with eccentric-oriented vs. traditional strength training for the ECC ... | PMC10305302 | |
2.4. Testing Procedures | PMC10305302 | |||
2.4.1. Isometric Leg Strength | The isometric leg strength test was executed on a flywheel device (D11 full, Desmotec, Biella, Italy), with peak force measured as an outcome. The participant wore a waist-fastened harness anchored to the strap and attached to the device, tightened so as not to allow vertical movement of the participant. The device has... | PMC10305302 | ||
2.4.2. Hop Tests | For the single-leg hop test (SLHU and SLHI for uninjured and injured legs, respectively), the participant is positioned on one leg, jumps horizontally with an all-out effort, and lands on the same limb with a controlled, balanced landing. With the triple jump test (TLHU and TLHI for uninjured and injured legs, respecti... | PMC10305302 | ||
2.4.3. Vertical Jump Tests | To perform a countermovement jump (CMJ), subjects were instructed to start with hands on the hips in an upright standing position, swiftly flex their knees to a semi-squat position, and immediately jump upward as high as possible while landing with knees extended. A contact mat (Just Jump, Probotics, Huntsville, AL, US... | PMC10305302 | ||
2.5. Statistical Analysis | Test results are presented as the mean ± standard deviation (SD). Before any statistical analysis, the normal distribution and homogeneity of the data were confirmed with the Shapiro-Wilk and Levenes tests, respectively. The test-retest reliability was assessed using an intraclass correlation coefficient (ICC) two-way ... | PMC10305302 | ||
3. Results | test-related injuries | All participants attended all training sessions without reporting any rehabilitation or test-related injuries. ECC and CON groups were similar for age (21.8 ± 4.6 vs. 19.1 ± 2.1 years), body mass (82.7 ± 16.6 vs. 76.6 ± 16.5 kg), and height (185.4 ± 12.2 vs. 182.5 ± 10.2 cm).A two-way analysis of variance revealed sign... | PMC10305302 | |
4. Discussion | BLIND | The present investigation aimed to compare the effects of 6 weeks of eccentric-oriented vs. traditional strength training on return-to-sport outcomes in late-stage ACL rehabilitation in professional team sport athletes. The study results showed that, although both training programs significantly improved all tested par... | PMC10305302 | |
Author Contributions | Conceptualization, M.D.M.S. and R.M.M.; Methodology, N.A., M.T. and B.V.; validation, M.T., M.M. and D.-N.Z.-Ș.; formal analysis, R.M.M. and M.T.; investigation, M.M.; resources, R.M.M. and M.D.M.S.; data curation, N.A., M.M., N.V. and D.-N.Z.-Ș.; writing—original draft preparation, M.D.M.S. and R.M.M.; writing—review ... | PMC10305302 | ||
Institutional Review Board Statement | The study was conducted according to the guidelines of the declaration of Helsinki and approved by the ethical committee of the University of Novi Sad (protocol number: 122/2020, approved date: 16 October 2020). | PMC10305302 | ||
Informed Consent Statement | Participants provided informed consent for their participation in the study. | PMC10305302 | ||
Data Availability Statement | The data are available upon reasonable request. | PMC10305302 | ||
Conflicts of Interest | The authors declare no conflict of interest. | PMC10305302 | ||
References | ± | Experimental protocol for the present study.Strength training program for the EXP and CON groups.Rehabilitation program weekly structure.Within-group differences, main and interaction effects, and effect sizes for selected variables.Pretest—initial test result ± standard deviation; Posttest—final test result ± standard... | PMC10305302 | |
Background | nonadherence, cardiometabolic diseases, DDIs, chronic disease | DISEASE PROGRESSION, CHRONIC DISEASE, DRUG-DRUG INTERACTION | Disentangling nonadherence (NA), drug-drug interactions (DDIs), and disease progression from each other is an important clinical challenge for providers caring for patients with cardiometabolic diseases. NAs and DDIs are both ubiquitous and often overlooked. We studied a novel chronic disease management (CDM) test to d... | PMC10105436 |
Materials and methods | We conducted a prospective, randomized controlled trial of 236 primary care physicians using computer-based, simulated patients, measuring clinical care with and without access to the CDM test. The primary outcomes were whether use of the CDM test increased the accuracy of diagnoses and ordering better treatments and h... | PMC10105436 | ||
Results | DISEASE PROGRESSION | Physicians given the CDM test results showed a + 13.2% improvement in their diagnosis and treatment quality-of-care scores (p < 0.001) in the NA patient cases and a + 13.6% improvement in the DDI cases (p < 0.001). The difference-in-difference calculations between the intervention and control groups were + 10.4% for NA... | PMC10105436 | |
Conclusion | nonadherence | DISEASE PROGRESSION | Distinguishing between nonadherence, drug-drug interactions, and disease progression is greatly improved using a reliable test, like the CDM test; improved diagnostic accuracy and treatment has the potential to improve patient quality of life, medication safety, clinical outcomes, and efficiency of health delivery. | PMC10105436 |
Trial Registration | clinicaltrials.gov (NCT05192590). | PMC10105436 | ||
Supplementary Information | The online version contains supplementary material available at 10.1186/s12875-023-02042-4. | PMC10105436 | ||
Keywords | PMC10105436 | |||
Background | cardiometabolic diseases, DDIs | DISEASE PROGRESSION, CHRONIC DISEASE | Treating cardiometabolic diseases relies on sustained efforts ranging from lifestyle modification, public health measures, and procedural interventions to achieve better health outcomes [The physician, already challenged to prescribe the appropriate medication at the correct dose, must also hope that patients take thei... | PMC10105436 |
Methods | PMC10105436 | |||
Overview | cardiometabolic disease, ®, DDIs | DISEASE PROGRESSION | Between October 2021 and February 2022, we conducted a prospective, cross-sectional RCT using simulated Clinical Performance and Value® (CPV®) vignettes. The study was conducted online and assessed the clinical utility of the CDM test among United States primary care physicians (PCPs) in the evaluation, work-up, diagno... | PMC10105436 |
Ethics | This study was conducted in accordance with ethical standards, approved by the Advarra Institutional Review Board, Columbia, MD, USA, and listed in clinicaltrials.gov (NCT05192590, 14/01/2022). Voluntary, informed consent was obtained from all participants. | PMC10105436 | ||
Sample Size Calculation | From previous work, we know that a 5% change in CPV scores are both statistically and clinically significant. [ | PMC10105436 | ||
Physician Selection | HF, HTN, atrial fibrillation, heart failure, hypertension | RECRUITMENT, HTN, ATRIAL FIBRILLATION, HEART FAILURE, HYPERTENSION, CORONARY ARTERY DISEASE, DIABETES (DM) | We recruited and enrolled practicing PCPs from a national roster. The eligibility criteria were: (1) board-certified, (2) currently practicing in internal or family medicine between 2 and 35 years, (3) practicing in a community or non-academic setting, (4) caring for more than 40 patients weekly, (5) commonly treating ... | PMC10105436 |
Intervention | We provided identical educational materials consisting of a physician-targeted slide deck, a fact sheet detailing the science behind the test, the sample collection method, and a sample report to both intervention groups, who were required to view these materials before progressing to round 2 and completing the study. ... | PMC10105436 | ||
Data sources | We had two sources of data: the physician survey and the physicians’ responses to the CPVs. | PMC10105436 | ||
Physician survey | After physicians were enrolled into the study, they were asked to answer a brief questionnaire detailing their practice characteristics, their patient level and types, and their own demographic background. The survey included questions on employment status, location of practice, practice type, and patient make-up, amon... | PMC10105436 | ||
Clinical Performance and Value (CPV) vignettes | CPVs are a validated online patient simulation tool owned by QURE Healthcare which have been widely used to measure clinical care [With between 61 and 74 evidence-based criteria evaluated for each CPV, participant responses were scored by two trained expert physicians, working independently, using pre-determined criter... | PMC10105436 | ||
Chronic cardiometabolic disease vignettes | nonadherence, DM/HTN | DISEASE PROGRESSION, DISEASE | We constructed nine CPV vignettes on a 3 × 3 matrix with three patient case types and three variants (see Supplement 2). The case types included patients with Afib, HF, or DM/HTN. The three variants included patients who were not at their therapeutic goal because of: medication nonadherence but no DDI (NA); because of ... | PMC10105436 |
Study outcomes and analysis | REGRESSION | The study sought to determine the clinical utility of the CDM test. Accordingly, the primary outcome is whether using CDM test improved patient care by increasing the diagnosis of NA or DDI Secondary outcomes included the effect of provider and clinical practice characteristics on care, cost implications of using the C... | PMC10105436 | |
Patient and Public Involvement | No patients involved. | PMC10105436 | ||
Results | PMC10105436 | |||
Physician Characteristics | 236 board-certified PCPs met the eligibility requirements, completed the physician questionnaire and six CPV patient cases (Table
Physician Baseline Characteristics, by Study Arm*One control participant missing data | PMC10105436 | ||
Diagnosis-and-Treatment Domain Scores | cardiometabolic diseases, DM/HTN | WEST | At baseline, we found wide variation in DxTx scores among participants caring for patients with cardiometabolic diseases. Across all patient cases, DxTx ranged from 0 to 75%, averaging 21.7%
Diagnosis-Treatment Scores by CPV VariantWe then compared control to the first intervention in a pre-post analysis. The formal di... | PMC10105436 |
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