Table 2.
Summary of Effects of Diabetes SMAs on Clinical and Economic Outcomes
| Number of studies (subjects)* | Domains pertaining to strength of evidence (SOE) | |||||
|---|---|---|---|---|---|---|
| Risk of bias: study design/quality | Consistency | Directness | Precision | Effect estimate (95 % CI) SOE |
||
| Clinical outcomes | ||||||
| A1c | 13 (2,921) | RCT/Good | Inconsistent | Direct | Some imprecision | MD −0.55 (−0.99 to −0.11) Moderate SOE |
| Blood pressure | 5 (1,125) | RCT/Good | Consistent | Direct | Some imprecision | MD −5.2 (−7.4 to −3.1) Moderate SOE |
| Total cholesterol | 5 (1,556) | RCT/Fair | Inconsistent | Direct | Imprecise | MD −4.9 (−17.8 to 7.9) Low SOE |
| LDL cholesterol | 5 (997) | RCT/Fair | Inconsistent | Direct | Imprecise | MD −6.6 (−16.1 to 2.8) Low SOE |
| Economic outcomes | ||||||
| Emergency department visits | 5 (1,339) | RCT/Good | Inconsistent | Direct | Imprecise | Lower rates in 2 of 5 studies Insufficient SOE |
| Hospitalizations | 5 (1,339) | RCT/Good | Consistent | Direct | Imprecise | Insignificantly lower rates in 4 of 5 studies Low SOE |
| Total costs | 4 (1,125) | RCT/Fair | Inconsistent | Direct | Imprecise | Total costs range from lower to higher Insufficient SOE |
*Studies (subjects) given are for randomized trials; observational studies were also considered in strength of evidence ratings, but are not listed separately in the table
Abbreviations: CI confidence interval; MD mean difference; NA not applicable; RCT randomized controlled trial; SOE strength of evidence