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. 2023 May 31;2023(5):CD014513. doi: 10.1002/14651858.CD014513

Gutierrez 2011.

Study characteristics
Methods Shared medical appointments in a residency clinic: an explanatory study among Hispanics with diabetes
Patient RCT, conducted in a family medicine residency clinic (for underserved and uninsured indigent populations), USA
Two arms: 1. Control (control arm) and 2. Shared medical appointments (intervention arm)
Participants Control arm N: 53
Intervention arm N: 50
Diabetes type: type 2
Mean age: NR ± NR
% Male: NR
Longest follow‐up: 17 months
Interventions Control arm:
None
Intervention arm:
1) Team changes
Outcomes 1) Aspirin, N users (%)
Control arm: pre 37 (70), post 36 (68)
Intervention arm: pre 29 (58), post 48 (96)
2) Retinopathy screening (eye exam), N screened (%)
Control arm: pre 36 (68), post 33 (62)
Intervention arm: pre 32 (64), post 46 (92)
3) Foot screening, N screened (%)
Control arm: pre 45 (85), post 32 (60)
Intervention arm: pre 34 (68), post 47 (94)
Funding source This study was supported by the Department of Family and Community Medicine, University of Texas Southwestern Medical School Parkland Family Medicine Clinic; by a Community Action Research Experience project funded by grant D58HP08301 from the Department of Health and Human Services Health Resources and Services Administration; and by a foundation grant from the Texas Academy of Family Physicians.
Notes
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote: "…table of random numbers."
Allocation concealment (selection bias) Unclear risk Not mentioned.
Patient's baseline characteristics (selection bias) Unclear risk Characteristics mentioned in text, but no data were presented.
Patient's baseline outcomes (selection bias) Unclear risk No baseline outcome measures provided.
Incomplete outcome data (attrition bias) Unclear risk No mention of losses to follow‐up; cannot assume 100% follow‐up unless specifically stated.
Blinding of participants and personnel (performance bias) and of outcome assessors (detection bias) High risk HbA1c measurement not described and outcome assessor was not blinded.
Selective reporting (reporting bias) Low risk < 2005 approach used since no protocol; they report all outcomes provided in methods.
Risk of contamination (other bias) High risk Quote: "Possibility of a halo effect exists, where providers participating in shared medical appointments (SMAs) could have gained new knowledge and insight that allowed them to better treat patients in the control group."
Other bias Low risk Information not available.