Results Summary and Professional Abstract
Final Research Report
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Related PCORI Dissemination and Implementation Project
|Article Highlight: This study compared three types of weight loss management programs for people with high blood pressure or type 2 diabetes who also had overweight or obesity. The study compared outcomes of patients in three groups: an online weight management program with meal plans, menus, and a weight tracker; that same program plus support from a health manager; and usual care. As reported in JAMA, the group that used the online weight management program and had access to a health manager, on average, experienced a statistically significant greater weight loss after 12 months compared to the other two groups.|
Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.
The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments.
Peer reviewers commented and the researchers made changes or provided responses. Those comments and responses included the following:
- The reviewers asked for more details about the role of the population health managers in conducting outreach and in monitoring patients’ progress on the online weight management program. Specifically, they asked whether records were kept of services that the population health managers delivered to study participants. The researchers said the study only collected the number of contacts the population health managers made with participants and no further information on the nature of those interactions. The researchers noted this as a limitation of the study.
- The reviewers asked about how much care was taken when collecting weight data for patients to ensure that the researchers measured weights accurately and consistently over time. The researchers said they did not perform any specific training on collecting weight data, but the primary care clinics used the same procedures to collect weight data for all visits. They noted that other studies have shown high agreement between weight data collected in clinic visits and weights that the researchers measured.
- The reviewers asked about subgroup analyses and recommended considering subgroups of patients with type 2 diabetes and hypertension for additional analyses. The reviewers noted that it would be helpful for clinicians to understand how these conditions could be affected by weight loss through this intervention. The researchers said they planned to conduct subgroup analyses by age, race, and education from the outset of their project. However, they did also add subgroup analyses for patients with type 2 diabetes and hypertension after collecting data.
- The reviewers noted that the researchers did not provide analyses to back up their assumptions regarding missing data in the sample. The researchers responded by conducting two different sensitivity analyses: one with only complete data and one using weighting to account for missing measurements. They also compared characteristics of patients with and without missing weight data and included all of these analyses as supplementary material for the report.
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