The DOI matches its Crossref record; 105 of the 187 references it cites were found in a registry or an index; none of the 14 sources its claims cite is checked for support yet.
Effect of telemedicine on glycated hemoglobin in diabetes: a systematic review and meta-analysis of randomized trials
Open accessAbstract
BACKGROUND: Telemedicine, the use of telecommunications to deliver health services, expertise and information, is a promising but unproven tool for improving the quality of diabetes care. We summarized the effectiveness of different methods of telemedicine for the management of diabetes compared with usual care. METHODS: We searched MEDLINE, Embase and the Cochrane Central Register of Controlled Trials databases (to November 2015) and reference lists of existing systematic reviews for randomized controlled trials (RCTs) comparing telemedicine with usual care for adults with diabetes. Two independent reviewers selected the studies and assessed risk of bias in the studies. The primary outcome was glycated hemoglobin (HbA1C) reported at 3 time points (≤ 3 mo, 4–12 mo and > 12 mo). Other outcomes were quality of life, mortality and episodes of hypoglycemia. Trials were pooled using randomeffects meta-analysis, and heterogeneity was quantified using the I2 statistic. RESULTS: From 3688 citations, we identified 111 eligible RCTs (n = 23 648). Telemedicine achieved significant but modest reductions in HbA1C in all 3 follow-up periods (difference in mean at ≤ 3 mo: −0.57%, 95% confidence interval [CI] −0.74% to −0.40% [39 trials]; at 4–12 mo: −0.28%, 95% CI −0.37% to −0.20% [87 trials]; and at > 12 mo: −0.26%, 95% CI −0.46% to −0.06% [5 trials]). Quantified heterogeneity (I2 statistic) was 75%, 69% and 58%, respectively. In meta-regression analyses, the effect of telemedicine on HbA1C appeared greatest in trials with higher HbA1C concentrations at baseline, in trials where providers used Web portals or text messaging to communicate with patients and in trials where telemedicine facilitated medication adjustment. Telemedicine had no convincing effect on quality of life, mortality or hypoglycemia. INTERPRETATION: Compared with usual care, the addition of telemedicine, especially systems that allowed medication adjustments with or without text messaging or a Web portal, improved HbA1C but not other clinically relevant outcomes among patients with diabetes.
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Claims the paper makes
48 Own result · 15 Own interpretation · 10 Not checked yet · 10 Own method · 2 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“| Partially reported | 22 | 0.30 (0.11 to 0.48) | 0.003 |”
§ Effect of telemedicine on > Conclusion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Choice of patienttoprovider platform (smartphone application, Web portal, smart device, telephone) did not significantly modify the effect of telemedicine on HbA 1C .”
§ Effect of telemedicine on > Meta-regression analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Tri als that partially reported loss to followup (i.e., no stated reasons for loss to followup, or loss was reported for the whole trial and not by group) showed a smaller difference in HbA 1C than trials with fully reported loss to followup or trials that did not report loss to followup (difference in MD 0.30%, 95% CI 0.11% to 0.48%).”
§ Effect of telemedicine on > Meta-regression analysis
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There was no evidence of selective reporting of subscores for quality of life.”
§ Effect of telemedicine on > % of studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The metaregression analyses suggested that telemedicine inter ventions that facilitated medication adjustments were more effec tive in improving glycemic control than interventions that did not al low such adjustements.”
§ Effect of telemedicine on > Interpretation
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“However, the effect of telemedicine was not significant for most subscores, and the few statistically significant differences were likely not clinically relevant.157”
§ Effect of telemedicine on > % of studies
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“| Medication adjustment | 40 | -0.23 (-0.42 to -0.05) | 0.01 |”
§ Effect of telemedicine on > Conclusion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, we found some evidence of publication bias, which sug gests that some small negative trials might exist, but they were not”
§ Effect of telemedicine on > Limitations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We also pooled the global scores (after transformation to a 1-100 range, where 100 was optimal) from all 3 diabetesspecific instruments from 8 trials (14 withintrial sub groups, n = 1324): MD 0.86 (95% CI -0.73 to 2.45; I 2 = 23%).”
§ Effect of telemedicine on > % of studies
plainn = 1,324- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Interventions in which providers adjusted medication in response to data from patients were also associated with larger improvements in HbA 1C (-0.23%, 95% CI -0.42% to -0.05%).”
§ Effect of telemedicine on > Meta-regression analysis
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 26
- It may state two separate claims as one. 44
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our literature search identified 3688 unique citations.After the screening of titles and abstracts, 517 potentially eligible studies were identified, of which 111 trials 21, met our inclusion criteria (Figure 1).”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Providers were nurses (37%), care managers (10%), diabetes educators (11%), physicians (29%), allied health profes sionals (17%; including dietitians, nutritionists, physiologists, exer cise trainers, psychologists and pharmacists), clinical decision sup port systems (32%) and nonspecialized support (23%; including trained peers, members of research teams, counsellors and com munity health care”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Because blinding of participants is not feasible for telemedicine interventions, all trials were open label to the participants; thus, every trial included at least 1 element of risk of bias.”
§ Effect of telemedicine on > Results
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was no evidence that telemedicine reduced the risk of hypoglycemic episodes (risk difference for hypoglycemic episodes ≤ 3 mo: 0.0%, 95% CI -5.5% to 5.5%, I 2 = 63%; and at 4-12 mo: 3.1%, 95% CI -7.9% to 14.2%, I 2 = 47%).”
§ Effect of telemedicine on > Effect on hypoglycemia
plainn = 462- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Both trial region and baseline HbA 1C modified the effect of telemedicine on final HbA 1C , but mean age, percent male, diabetes duration, BMI, insulin use, use of oral hypoglycemic therapy and diabetes type did not.”
§ Effect of telemedicine on > Meta-regression analysis
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The trials used a large variety of plat forms: Web portal (24%), customized”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Risk differences for severe hypogly cemia were also not significant (≤ 3 mo: 0.0%, 95% CI -4.2% to 4.2%; and at 4-12 mo: -0.1%, 95% CI -1.0% to 0.8%, I 2 = 0%).”
§ Effect of telemedicine on > Effect on hypoglycemia
plainn = 1,259- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and > 12 mo: -0.26%, 95% CI -0.46% to -0.06%,I 2 = 58%).”
§ Effect of telemedicine on > Effect on HbA 1C
plaindirectn = 1,896- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, we did not find good evi dence that telemedicine reduced the risk of hypoglycemia, quality of life or mortality, although it is unlikely that benefits for the latter would have been observed given the short duration of the included trials.”
§ Effect of telemedicine on > Interpretation
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The platforms used were telephone (59%), clinical decision support system (32%; e.g., automated interactive voice [9%]), Web portal (22%), SMS (16%), email (7%), videoconference (4%), computer software (3%), customized”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The risk differences were all nonsignificant, without evidence of heteroge neity (≤ 3 mo: 0.2%, 95% CI -0.6% to 0.9%, I 2 = 0%, 6 deaths; 4-12 mo: -0.2%, 95% CI -0.6% to 0.2%, I 2 = 0%, 68 deaths; and > 12 mo: -0.3%, 95% CI -1.6% to 1.0%, I 2 = 0%, 351 deaths).”
§ Effect of telemedicine on > % of studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most (94%) of the interventions were interactive, whereby the patient could communicate with the provider, and the provider could communicate with the patient.”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The contour funnel plot of HbA 1C was asymmetrical, consistent with publication bias (more small studies favouring telemedicine) (Figure 4).”
§ Effect of telemedicine on > Effect on HbA 1C
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Frequency of contact and type of pro vider did not significantly modify the association.”
§ Effect of telemedicine on > Meta-regression analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The bias estimate from the regression analysis was signifi cant (Egger test: bias -0.95, p = 0.02).”
§ Effect of telemedicine on > Effect on HbA 1C
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The range of meta bolic control at baseline varied substantially between trials (mean HbA 1C 6.4%-10.9%);however, the mean HbA 1C level in 71 (64%) of the trials was 8% or greater at baseline.”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Three scores or subscores showed significant worsening (SF36 physical functioning ≤ 3 mo: MD -3.98, 95% CI -0.62 to -7.34,I 2 = 30%, 2 trials, n = 311; SF36 social functioning ≤ 3 mo: MD -2.22, 95% CI -0.10 to -4.34,I 2 = 0%, 2 trials, n = 311; and EQ5D at 4-12 mo: MD -0.01, 95% CI -0.01 to -0.01, 2 trials, n = 743).”
§ Effect of telemedicine on > % of studies
plaindirectn = 743 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The median mean age at baseline was 56 years, and the median mean BMI at baseline was 31.”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The median number of study participants was 114 (range 10-2378) (Table 1).”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“4-12 mo: -0.28%, 95% CI -0.37% to -0.20%,I 2 = 69% [Figure 3];”
§ Effect of telemedicine on > Effect on HbA 1C
plaindirectn = 15,524- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Seventyeight trials (70%) reported and described an appropriate method of randomization, but only 30 (27%) reported an adequate allocation concealment process.The intentiontotreat principle was applied in 51 (46%) of the trials.Public funding was exclusively used in 57 trials (51%).”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Other frequent compo nents of the interventions included general diabetes education (76%), nutritional interventions (53%), exercise (49%) and blood pressure management (9%).”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Because there was no gradient of effect, there was no evidence that reporting versus not reporting loss to followup was a signifi cant effect modifier.”
§ Effect of telemedicine on > Meta-regression analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“with both SMS text messaging and Web portal associated with greater benefit than telephonebased systems (difference in MD: SMS v. telephone -0.28%, 95% CI -0.52% to -0.05%; Web portal v. telephone -0.35%, 95% CI -0.56% to -0.14%).”
§ Effect of telemedicine on > Meta-regression analysis
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Inclusion of interactive com munication, exercise, general diabetes education, blood pressure management or nutritional interventions did not modify the bene fit of telemedicine on HbA 1C .”
§ Effect of telemedicine on > Meta-regression analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Interactive telecommunica tion initiated by providers occurred in the following frequencies: at least daily (8%), weekly (26%), every 2 weeks (10%), monthly (16%) or less often (7%).Frequency of interaction was not reported in 33% of trials.”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The MDs were all significant and favoured telemedicine, although there was large heterogeneity (≤ 3 mo: -0.57%, 95% confidence interval [CI] -0.74% to -0.40%,I 2 = 75%;”
§ Effect of telemedicine on > Effect on HbA 1C
plaindirectn = 3,165- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of the 111 included trials, 4 were published before 2000.Five were cluster RCTs, 3 were crossover trials, and the remainder were parallel RCTs.”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When the 3 outlier trials were removed, the bias estimate was not significant (bias -0.68, p = 0.07).”
§ Effect of telemedicine on > Effect on HbA 1C
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Exclusion of these 3 trials did not materially affect our results for the primary outcome (HbA 1C at 4-12 mo), but it did reduce heterogeneity (-0.24%, 95% CI -0.31% to -0.16%,I 2 = 58%).”
§ Effect of telemedicine on > Effect on HbA 1C
plaindirectn = 15- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Many of the interventions (45%) adjusted medication based on the data received.”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, we assessed for blinding of outcome assessors (present in 20% of trials).”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Findings were similar when control of HbA 1C was dichotomized at various thresholds (6.4%-6.5%,7%-7.5%,8% or 9%) and when we pooled results from the last time points from every available trial”
§ Effect of telemedicine on > Effect on HbA 1C
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“European (n = 26) and North American trials (reference group, n = 47) reported simi lar MDs (difference in MD -0.08%, 95% CI -0.27% to 0.11%);”
§ Effect of telemedicine on > Meta-regression analysis
plainn = 26- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We pooled the mental health and physical health component summaries of the SF36 and SF12 instruments from 7 trials (n = 1333): MD 0.55 (95% CI -0.83 to 1.92; I 2 = 29%) and 0.06 (95% CI -1.01 to 1.13; I 2 = 0%), respectively.”
§ Effect of telemedicine on > % of studies
plainn = 1,333- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Fortyone trials (37%) were done in the United States, 14 (13%) in Korea and 7 (6%) each in Canada and Australia; 6 or fewer were done in each of the remaining countries.”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Disagreements occurred with 7% of the articles (κ value = 0.82).”
§ Effect of telemedicine on > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Disagreements between the reviewers were resolved by meeting with a third reviewer (N.W.).”
§ Effect of telemedicine on > Study selection
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Two reviewers (L.F. and a research assistant) assessed the trials independently and resolved any disagreements by meeting with a third reviewer (N.W.).”
§ Effect of telemedicine on > Risk-of-bias assessment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We planned a priori to examine the association between popu lation characteristics, intervention characteristics, riskofbias items (as specified earlier) and the effect of telemedicine on HbA 1C for characteristics reported in 5 or more trials.”
§ Effect of telemedicine on > Data synthesis and analysis
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The review was reported according to an accepted guide line.32”
§ Effect of telemedicine on > Methods
What the sources say
- Not checked yetcites [32] 32. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting system atic reviews and metaanalyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009;339:b2700.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“We assessed publication bias using the Egger test 44 and by visual inspection of the contourenhanced funnel plot.45”
§ Effect of telemedicine on > Data synthesis and analysis
What the sources say
- Not checked yetcites [44] 44. Egger M, Davey Smith G, Schneider M, et al. Bias in metaanalysis detected by a sim ple, graphical test. BMJ 1997;315:62934.
- Not checked yetcites [45] 45. Peters JL, Sutton AJ, Jones DR, et al. Contourenhanced metaanalysis funnel plots help distinguish publication bias from other causes of asymmetry. J Clin Epidemiol 2008;61:9916.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Two reviewers (N.W. and L.F.) independently screened the titles and abstracts of all unique citations.”
§ Effect of telemedicine on > Study selection
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“We assessed risk of bias using the Cochrane Collaboration's tool 33 and included other items (funding, intention to treat and interim analysis) also known to be associated with bias.[34][35][36][37][38][39][40]”
§ Effect of telemedicine on > Risk-of-bias assessment
What the sources say
- Not checked yetcites [33] 33. Higgins JPT, Altman DG, Sterne JAC. Chapter 8: Assessing risk of bias in included studies. In: Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration; 2011.
- Not checked yetcites [34] 34. Jüni P, Altman DG, Egger M. Assessing the quality of randomised controlled tri als. In: Egger M, Davey Smith G, Altman DG, editors. Systematic reviews in health care. 2nd ed. London (UK): BMJ Books; 2001.
- Not checked yetcites [35] 35. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of ran domized clinical trials: is blinding necessary? Control Clin Trials 1996;17:112.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Data from eligible trials were extracted by 1 reviewer (L.F.) and checked by another reviewer (Y.L.) using a standardized extraction sheet.”
§ Effect of telemedicine on > Data extraction
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Two independent reviewers (L.F. and a research assistant) assessed them using an inclusion/exclusion form based on a priori selection criteria for eligibility.”
§ Effect of telemedicine on > Study selection
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We were also able to show that effects on HbA 1C diminished but were sustained over time”
§ Effect of telemedicine on > Interpretation
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Third, as with all metaregression analyses using summary data rather than individual participant data, our findings are vulnerable to the ecological fallacy (i.e., findings at the population level do not always translate correctly to individuals) and from limited sta tistical power.”
§ Effect of telemedicine on > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Weaknesses of our systematic review include limitations of the constituent trials (small sample size, lack of blinding and rela tively short duration).”
§ Effect of telemedicine on > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Because all of these findings were nonsignificant, 157 there was no evidence to suggest that telemedicine enhanced quality of life.”
§ Effect of telemedicine on > % of studies
What the sources say
- Not checked yetcites [157] 157. Samsa G, Edelman D, Rothman ML, et al. Determining clinically important dif ferences in health status measures: a general approach with illustration to the Health Utilities Index Mark II. Pharmacoeconomics 1999;15:14155.
hedgedn = 1,324- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The variation may have con tributed to the observed heterogeneity, and it may explain why some trials found positive effects of telemedicine and others found no benefit.”
§ Effect of telemedicine on > Limitations
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Nonetheless, the effect on HbA 1C appears clinically relevant and is comparable to improvements associated with some oral antidiabetic agents (0.5%-1.25%), 158 psychosocial interventions (0.6%, 95% CI -1.2% to -0.1%) 159 or quality improvement strategies (0.42%, 95% CI 0.29% to 0.54%) 160 among patients with diabetes.”
§ Effect of telemedicine on > Interpretation
What the sources say
- Not checked yetcites [158] 158. Sherifali D, Nerenberg K, Pullenayegum E, et al. The effect of oral antidiabetic agents on A1C levels: a systematic review and metaanalysis. Diabetes Care 2010;33:185964.
- Not checked yetcites [159] 159. Armour TA, Norris SL, Jack L Jr, et al. The effectiveness of family interventions in people with diabetes mellitus: a systematic review. Diabet Med 2005; 22:1295305.
- Not checked yetcites [160] 160. Shojania KG, Ranji SR, McDonald KM, et al. Effects of quality improvement strategies for type 2 diabetes on glycemic control: a metaregression analysis. JAMA 2006;296:42740.
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The use of SMS text messaging may be feasible to communicate and motivate patients, which could result in positive outcomes.134”
§ Effect of telemedicine on > Interpretation
What the sources say
- Not checked yetcites [134] 134. Shetty AS, Chamukuttan S, Nanditha A, et al. Reinforcement of adherence to prescription recommendations in Asian Indian diabetes patients using short message service (SMS) -a pilot study. J Assoc Physicians India 2011;59:7114.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The lower apparent magnitude of benefit with longer followup may reflect reduced adherence to the intervention.”
§ Effect of telemedicine on > Interpretation
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This wide variation in inter ventions likely contributed to some of the observed heterogeneity, which was only partly explained by metaregression.”
§ Effect of telemedicine on > Interpretation
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This finding is consistent with medication adjustment by nurse or pharmacist (0.23%, 95% CI 0.05% to 0.42%) reported in a previous metaregression analysis of quality improve ment strategies, including case man agement.160”
§ Effect of telemedicine on > Interpretation
What the sources say
- Not checked yetcites [160] 160. Shojania KG, Ranji SR, McDonald KM, et al. Effects of quality improvement strategies for type 2 diabetes on glycemic control: a metaregression analysis. JAMA 2006;296:42740.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
Telemedicine may be helpful for providing care to people with diabetes, especially those unable to travel to health care facilities because of large distances or disabilities.
“It may also be helpful for providing care to people with diabetes, especially those unable to travel to health care facilities owing to large distances or disabilities.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source doesn’t support the claim as written.
In the citing paper
“The included studies exhibited substantial heterogeneity (I²=94%), a common finding in telemedicine reviews, where heterogeneity typically ranges from 65% to 99% [17,22,86,93].”
From Clinical Improvements From Telemedicine Interventions for Managing Type 2 Diabetes Compared With Usual Care: Systematic Review, Meta-Analysis, and Meta-Regression (2026) · cites this paper as [93]
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredThe cited source doesn’t support the claim as written.
In the citing paper
“3 reviews [28, 31, 43] reported that interventions as simple as text-messaging or SMS feedback were equally effective in improving HbA1c, compared to a teleconference or telephone appointment with healthcare professionals.”
From Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis (2025) · cites this paper as [31]
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The included studies exhibited substantial heterogeneity (I²=94%), a common finding in telemedicine reviews, where heterogeneity typically ranges from 65% to 99% [17,22,86,93].”
From Clinical Improvements From Telemedicine Interventions for Managing Type 2 Diabetes Compared With Usual Care: Systematic Review, Meta-Analysis, and Meta-Regression (2026) · cites this paper as [93]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Consistent with previous findings [87,93], the majority of the evidence (72%) originates from high-income countries, with the United States contributing the highest proportion (28%).”
From Clinical Improvements From Telemedicine Interventions for Managing Type 2 Diabetes Compared With Usual Care: Systematic Review, Meta-Analysis, and Meta-Regression (2026) · cites this paper as [93]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Messages generated using automated algorithms may offer a more feasible and less expensive solution [31].”
From Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis (2025) · cites this paper as [31]
In the citing paper
“In contrast to our findings, Faruque et al found a larger effect in studies that used web portals or text messaging. 13”
From The Effectiveness of Telemedicine Solutions for the Management of Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression (2023) · cites this paper as [13]
In the citing paper
“The results reflect the findings from previous systematic reviews, which have found significant reductions in HbA1c favoring telemedicine.13,22,283,284”
From The Effectiveness of Telemedicine Solutions for the Management of Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression (2023) · cites this paper as [13]
In the citing paper
“A potential solution to support ongoing diabetes self-management support is the use of telemedicine, 12 which has been suggested as a promising but unproven approach to support people with diabetes in the management of their disease. 13”
From The Effectiveness of Telemedicine Solutions for the Management of Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression (2023) · cites this paper as [13]
In the citing paper
“In line with our findings, Faruque et al and Wu et al found a larger effect among studies with a higher baseline HbA1c.13,283”
From The Effectiveness of Telemedicine Solutions for the Management of Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression (2023) · cites this paper as [13]
In the citing paper
“Hence, the large heterogeneity found in the present review is not unusually large when compared with similar reviews.”
From The Effectiveness of Telemedicine Solutions for the Management of Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression (2023) · cites this paper as [13]
In the citing paper
“In the before-mentioned systematic review by Faruque et al, the heterogeneity (I2) ranged from 58% to 75% depending on the time point Hba1c was measured. 13”
From The Effectiveness of Telemedicine Solutions for the Management of Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression (2023) · cites this paper as [13]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Effect of telemedicine on > Meta-regression analysis
“Both trial region and baseline HbA 1C modified the effect of telemedicine on final HbA 1C”
§ Effect of telemedicine on > Limitations
“Baseline HbA 1C (range 6.4%-10.7%)87 -0.06 per 1% (-0.16 to 0.04) 0.3 68”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Effect of telemedicine on > Limitations
“Duration of followup (range 2.6-24 yr) 52 0.008 per 1 yr (-0.02 to 0.03) 0.5 69”
§ Effect of telemedicine on > Effect on HbA 1C
“Thirtynine trials (n = 3165) reported the effect of telemedicine on HbA 1C at 3 months or less”
Citations
Cites
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164
(1993) · New England Journal of Medicine · doi:10.1056/nejm199309303291401 · Cited by 24,667
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · BMJ · doi:10.1136/bmj.b2700 · Cited by 17,648
Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay, H. J. (1996) · Controlled Clinical Trials · doi:10.1016/0197-2456(95)00134-4 · Cited by 17,582
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00136 · Cited by 10,349
Stratton, I. M. (2000) · BMJ · doi:10.1136/bmj.321.7258.405 · Cited by 9,059
Downs, S. H., & Black, N. (1998) · Journal of Epidemiology and Community Health · doi:10.1136/jech.52.6.377 · Cited by 8,252
Schulz (1995) · doi:10.1001/jama.1995.03520290060030 · Cited by 5,634
Dong, Y., Hao, L., Shi, Z., Wang, G., Zhang, Z., & Han, C. (2013) · Urologia Internationalis · doi:10.1159/000351405 · Cited by 4,557
(2008) · Cited by 3,790
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“The use of theory was reported in only four studies.(41,47,51,67) The Transtheoretical model, Health Belief Model, Self-determination Theory, Social Cognitive Theory and Information-Motivation-Behavioral Skills model were used to guide the tailoring of intervention components and message content in the interventions.”
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“Telemedicine interventions appear to be most effective when HCP used Web portals or text messaging to communicate with patients and when telemedicine facilitated medication adjustment.(47) A recent randomized-controlled trial involving 74 T1D adults followed for 1 year showed similar reductions in HbA1c between those…”
BackgroundHou, C., Xu, Q., Diao, S., Hewitt, J., Li, J., & Carter, B. (2018) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.13307 · Cited by 127
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“7% in 2030.([2]) Diabetic neuropathy is a heterogeneous group of complex pathophysiological disorders, which affects both somatic and autonomic components of the nervous system.”
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Patient-Driven Diabetes Care of the Future in the Technology Era
Ashrafzadeh, S., & Hamdy, O. (2019) · Cell Metabolism · doi:10.1016/j.cmet.2018.09.005 · Cited by 111
Digital health technology and diabetes management: 数字化医疗技术与糖尿病管理
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Telemedicine in Complex Diabetes Management
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1. Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes—2018
American Diabetes Association (2017) · Diabetes Care · doi:10.2337/dc18-s001 · Cited by 105
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“However, digital diabetes care has shown only modest HbA 1c improvement in multiple studies [16].”
Remote Patient Management for Home Dialysis Patients
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“Furthermore, diabetesrelated telehealth programs with the ability to change medications remotely have been shown to lower hemoglobin A1c as compared to standard of care.(24) However, there is still uncertainty about the role of RPM for home dialysis.”
BackgroundAdoption of Telemedicine for Type 1 Diabetes Care During the COVID-19 Pandemic
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Telehealth for the Longitudinal Management of Chronic Conditions: Systematic Review
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“Extensive literature supports telehealth as a supplement or adjunct to in-person care for the management of chronic conditions [11] such as congestive heart failure (CHF) and type 2 diabetes mellitus (T2DM) [12-14].”
Clement, M., Filteau, P., Harvey, B., Jin, S., Laubscher, T., Mukerji, G., & Sherifali, D. (2018) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2017.10.005 · Cited by 57
Teleconsultation in type 1 diabetes mellitus (TELEDIABE)
Bertuzzi, F., Stefani, I., Rivolta, B., Pintaudi, B., Meneghini, E., Luzi, L., & Mazzone, A. (2018) · Acta Diabetologica · doi:10.1007/s00592-017-1084-9 · Cited by 58
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Warren, R., Carlisle, K., Mihala, G., & Scuffham, P. A. (2018) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x17723943 · Cited by 54
Nick, J. M., Roberts, L. R., & Petersen, A. B. (2021) · JBI Evidence Synthesis · doi:10.11124/jbies-20-00329 · Cited by 52
Hangaard, S., Laursen, S. H., Andersen, J. D., Kronborg, T., Vestergaard, P., Hejlesen, O., & Udsen, F. W. (2023) · Journal of Diabetes Science and Technology · doi:10.1177/19322968211064633 · Cited by 55
Implications of the COVID-19 Pandemic for Cardiovascular Disease and Risk-Factor Management
Lau, D., & McAlister, F. A. (2020) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2020.11.001 · Cited by 55
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Limbert, C., Tinti, D., Malik, F. S., Kosteria, I., Messer, L. H., Jalaludin, M. Y., Benitez‐Aguirre, P., Biester, S., Corathers, S. D., von Sengbusch, S., et al. (2022) · Pediatric Diabetes · doi:10.1111/pedi.13417 · Cited by 59
“munications to deliver health services, including interactive, consultative, and diagnostic services.(38,39) The most used approaches are virtual visits via video, telephone, or live chat.”
BackgroundCorreia, J. C., Meraj, H., Teoh, S. H., Waqas, A., Ahmad, M., Lapão, L. V., Pataky, Z., & Golay, A. (2021) · Bulletin of the World Health Organization · doi:10.2471/blt.19.250068 · Cited by 42
Six Digital Health Technologies That Will Transform Diabetes
Klonoff, A. N., Lee, W.-A. (., Xu, N. Y., Nguyen, K. T., DuBord, A., & Kerr, D. (2023) · Journal of Diabetes Science and Technology · doi:10.1177/19322968211043498 · Cited by 44
Illuminating Healthcare Management: A Comprehensive Review of IoT-Enabled Chronic Disease Monitoring
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Managing Diabetes in Hard to Reach Populations: A Review of Telehealth Interventions
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Impact of Telehealth Interventions on Processes and Quality of Care for Patients With ESRD
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Self-citationEvidence and User Considerations of Home Health Monitoring for Older Adults: Scoping Review
Chan, A., Cohen, R., Robinson, K.-M., Bhardwaj, D., Gregson, G., Jutai, J. W., Millar, J., Rincon, A. M. R., & Fekr, A. R. (2022) · JMIR Aging · doi:10.2196/40079 · Cited by 41
Using Digital Health Technology to Prevent and Treat Diabetes
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“We also found that telemedicine interventions with medication dose adjustment reported significant treatment effects in improving glycemic control in children and adolescents, consistent with the results of a study [55] on the effects of telemedicine on HbA 1c levels in patients with diabetes.”
InfluentialNew and Emerging Technologies in Type 1 Diabetes
Sherwood, J. S., Russell, S. J., & Putman, M. S. (2020) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2020.07.006 · Cited by 46
“A recent meta-analysis found that telehealth intervention in patients with diabetes led to HbA1c improvements.(45) Concerns about spread of SARS-CoV-2 have dramatically increased use of telehealth visits for diabetic patients over a very short period of time in the first quarter of 2020 and will likely accelerate the…”
BackgroundRealising the potential of mHealth to improve asthma and allergy care: how to shape the future
Bousquet, J. J., Chavannes, N. H., Guldemond, N., Haahtela, T., Hellings, P. W., & Sheikh, A. (2017) · European Respiratory Journal · doi:10.1183/13993003.00447-2017 · Cited by 41
Appropriate Use of Telehealth Visits in Endocrinology: Policy Perspective of the Endocrine Society
Vimalananda, V. G., Brito, J. P., Eiland, L. A., Lal, R., Maraka, S., McDonnell, M. E., Narla, R. R., Roth, M. Y., & Crossen, S. S. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac494 · Cited by 35
Tu, Y.-Z., Chang, Y.-T., Chiou, H., & Lai, K. (2021) · Journal of Medical Internet Research · doi:10.2196/23227 · Cited by 31
Galindo, R. J., Parkin, C. G., Aleppo, G., Carlson, A. L., Kruger, D. F., Levy, C. J., Umpierrez, G. E., & McGill, J. B. (2021) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2021.0107 · Cited by 38
Mabeza, R. M. S., Maynard, K., & Tarn, D. M. (2022) · BMC Primary Care · doi:10.1186/s12875-022-01662-6 · Cited by 34
Cheung, N. W., Redfern, J., Thiagalingam, A., Hng, T., Marschner, S. L., Haider, R., Faruquie, S., Huben, A. V., She, S., McIntyre, D., et al. (2023) · Journal of Medical Internet Research · doi:10.2196/38275 · Cited by 29
“A meta-regression analysis of telemedicine trials for diabetes found that interventions that included provider-to-patient messaging and those in which providers adjusted medication in response to data from patients were more effective [29].”
Udsen, F. W., Hangaard, S., Bender, C., Andersen, J., Kronborg, T., Vestergaard, P., Hejlesen, O., & Laursen, S. (2022) · Journal of Diabetes Science and Technology · doi:10.1177/19322968221076874 · Cited by 27
Steenkamp, D., Eby, E. L., Gulati, N., & Liao, B. (2022) · Journal of Diabetes Science and Technology · doi:10.1177/1932296821997923 · Cited by 33
Tan, E. J. H., Khoo, J. J. C., Gani, L. U., Malakar, R. D., Tay, T. L., Tirukonda, P. S., Kam, J. W., Tin, A. S., & Tang, T. Y. (2019) · Trials · doi:10.1186/s13063-019-3601-3 · Cited by 42
“Previous trials have also suggested the utility of the chronic care model [5], structured recall [6], regular nurse contact [7], technology-enabled diabetes self-management education and support [8, 9] and a multifaceted approach in dealing with diabetes mellitus [6].”
Backgroundde Souza, C. F., Dalzochio, M. B., Zucatti, A. T. N., de Nale, R., de Almeida, M. T., Gross, J. L., & Leitão, C. B. (2017) · Endocrine · doi:10.1007/s12020-017-1352-z · Cited by 31
Greenwood, D. A., Litchman, M. L., Isaacs, D., Blanchette, J. E., Dickinson, J. K., Hughes, A., Colicchio, V. D., Ye, J., Yehl, K., Todd, A., et al. (2022) · Journal of Diabetes Science and Technology · doi:10.1177/19322968211036430 · Cited by 31
Rodríguez‐Fortúnez, P., Franch‐Nadal, J., Fornos-Pérez, J. A., Martínez‐Martínez, F., de Paz, H. D., & Peña, M. L. O. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-028467 · Cited by 29
“With regard to TM resources, Faruque et al found that TM programmes that used online platforms and text messages that allowed patient-physician communication were significantly more effective at glycaemic control (HbA1c levels) by allowing treatment to be adjusted.(13) This was one of the types of platform that arouse…”
BackgroundResultInfluentialGrady, M., Katz, L. B., Cameron, H., & Levy, B. L. (2017) · JMIR Diabetes · doi:10.2196/diabetes.7454 · Cited by 29
Challenges for the adoption of ICT for diabetes self‐management in South Africa
Petersen, F., Brown, A., Pather, S., & Tucker, W. D. (2020) · THE ELECTRONIC JOURNAL OF INFORMATION SYSTEMS IN DEVELOPING COUNTRIES · doi:10.1002/isd2.12113 · Cited by 31
Early diagnosis of diabetic peripheral neuropathy based on infrared thermal imaging technology
Zhou, Q., Qian, Z., Wu, J., Liu, J., Ren, L., & Ren, L. (2020) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3429 · Cited by 29
Lewinski, A. A., Drake, C., Shaw, R. J., Jackson, G. L., Bosworth, H. B., Oakes, M. M., Gonzales, S. E., Jelesoff, N. E., & Crowley, M. J. (2019) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocz039 · Cited by 28
Kobe, E. A., Lewinski, A. A., Jeffreys, A. S., Smith, V. A., Coffman, C. J., Danus, S. M., Sidoli, E., Greck, B. D., HORNE, L. C., Saxon, D. R., et al. (2022) · Journal of General Internal Medicine · doi:10.1007/s11606-021-07281-8 · Cited by 36
Zupa, M. F., Vimalananda, V. G., Rothenberger, S. D., Lin, J. Y., Ng, J. M., McCoy, R. G., & Rosland, A.-M. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.46305 · Cited by 27
Liao, X., Li, S., Akkawi, M. M. E., Fu, X., Liu, H., & Huang, Y. (2022) · Frontiers in Surgery · doi:10.3389/fsurg.2022.1003339 · Cited by 33
Gujral, U. P., Johnson, L. C. M., Nielsen, J., Vellanki, P., HAW, J. S., Davis, G. M., Weber, M. B., & Pasquel, F. J. (2020) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2020-001520 · Cited by 31
Michaud, T. L., Ern, J., Scoggins, D., & Su, D. (2021) · Telemedicine and e-Health · doi:10.1089/tmj.2019.0319 · Cited by 28
“8 Extensive research has demonstrated the effectiveness of telehealth technologies, such as computer-based interventions, 9 web-based interventions, 10,11 and mobile phone application 6,12,13 on the management of diabetes.”
Pekmezaris, R., Williams, M. S., Pascarelli, B., Finuf, K. D., Harris, Y. T., Myers, A. K., Taylor, T., Kline, M., Patel, V. H., Murray, L. M., et al. (2020) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-020-01346-0 · Cited by 26
“One meta-analysis of randomized trials using home telemonitoring showed improvements in Type 2 Diabetes patient problem areas [18].”
MethodChakranon, P., Lai, Y. K., Tang, Y. W., Choudhary, P., Khunti, K., & Lee, S. W. H. (2019) · Diabetic Medicine · doi:10.1111/dme.14156 · Cited by 26
Khalid, A., Dong, Q., Chuluunbaatar, E., Haldane, V., Durrani, H., & Wei, X. (2023) · Journal of Medical Internet Research · doi:10.2196/42134 · Cited by 27
Paalimäki‐Paakki, K., Virtanen, M. A., Henner, A., Nieminen, M. T., & Kääriäinen, M. (2022) · Journal of Medical Internet Research · doi:10.2196/30077 · Cited by 32
Diabetes clinic reinvented: will technology change the future of diabetes care?
Al-Badri, M. R., & Hamdy, O. (2021) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018821995368 · Cited by 27
Myers, A. K., Presswala, L. S., Bissoonauth, A. A., Gulati, N., Zhang, M., Izard, S. M., Kozikowski, A., Meyers, K., & Pekmezaris, R. (2020) · Journal of Diabetes Science and Technology · doi:10.1177/1932296820951784 · Cited by 26
Impact of telemedicine on assisted reproduction treatment in the public health system.
Hernandez, C., Valdera, C., Cordero, J., Lopez, E., Plaza, J., & Albi, M. (2019) · Journal of Healthcare Quality Research · doi:10.1016/j.jhqr.2019.08.004 · Cited by 25
Effect of Health Information Technologies on Glycemic Control Among Patients with Type 2 Diabetes
Yoshida, Y., Boren, S. A., Soares, J., Popescu, M., Nielson, S. D., & Simões, E. J. (2018) · Current Diabetes Reports · doi:10.1007/s11892-018-1105-2 · Cited by 26
Carlson, A. L., Martens, T. W., Johnson, L., & Criego, A. B. (2021) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2021.0241 · Cited by 28
Chan, C. B., Popeski, N., Hassanabad, M. F., Sigal, R. J., O’Connell, P., & Sargious, P. M. (2021) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2021.02.007 · Cited by 24
Hawes, E. M., Lambert, E., Reid, A., Tong, G., & Gwynne, M. D. (2018) · American Journal of Health-System Pharmacy · doi:10.2146/ajhp170174 · Cited by 24
Dahy, A., El‐Qushayri, A. E., Mahmoud, A. R., Al‐kelany, T. A., & Salman, S. (2020) · Dermatologic Therapy · doi:10.1111/dth.13908 · Cited by 25
The Final Frontier in Diabetes Care: Implementing Research in Real-World Practice
Green, J. B., Crowley, M. J., Sathish, T., Maruthur, N. M., & Oldenburg, B. F. (2024) · Diabetes Care · doi:10.2337/dci24-0001 · Cited by 31
Gómez, A. M., Henao, D. C., Vargas, F. M. L., Múñoz, Ó., Pantoja, Ó. D. L., Maira, G., Aldea, A., Martin, C. E., Hortúa, L. M. R., Reyes, C. P. R., et al. (2022) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2022.109948 · Cited by 25
Effectiveness of telepharmacy diabetes services: A systematic review and meta-analysis
Cao, D. X., Tran, R. J. C., Yamzon, J., Stewart, T. L., & Hernandez, E. A. (2022) · American Journal of Health-System Pharmacy · doi:10.1093/ajhp/zxac070 · Cited by 27
Валерьевна, Ч. В., Shapovalova, M. A., Chichkova, M. A., & Antsiferov, M. B. (2023) · Diabetes Mellitus · doi:10.14341/dm13019 · Cited by 24
Laursen, S. H., Boel, L., Udsen, F. W., Secher, P. H., Andersen, J. S., Vestergaard, P., Hejlesen, O. K., & Hangaard, S. (2022) · Journal of Diabetes Science and Technology · doi:10.1177/19322968221094626 · Cited by 24
Bellido, V., & Pérez, A. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10225341 · Cited by 26
Review of Systematic Reviews in the Field of Telemedicine
Goharinejad, S., Hajesmaeel-Gohari, S., Jannati, N., Goharinejad, S., & Bahaadinbeigy, K. (2021) · Medical Journal of The Islamic Republic of Iran · doi:10.47176/mjiri.35.184 · Cited by 18
Diabetic foot disease: a systematic literature review of patient-reported outcome measures
Pérez-Panero, A. J., Ruiz‐Muñoz, M., Fernández-Torres, R., Formosa, C., Gatt, A., & González‐Sánchez, M. (2021) · Quality of Life Research · doi:10.1007/s11136-021-02892-4 · Cited by 20
Instruments of Choice for Assessment and Monitoring Diabetic Foot: A Systematic Review
Fernández-Torres, R., Ruiz‐Muñoz, M., Pérez-Panero, A. J., García-Romero, J., & González‐Sánchez, M. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9020602 · Cited by 20
“Furthermore, it is the main cause of hospitalization and amputation in diabetic patients [5], to the extent that one limb is amputated every 30 s [2].”
BackgroundInfluentialUchiyama, K., Washida, N., Yube, N., Kasai, T., Shinozuka, K., Morimoto, K., Hishikawa, A., Inoue, H., Urai, H., Hagiwara, A., et al. (2018) · Clinical Nephrology · doi:10.5414/cn109471 · Cited by 19
Technology Interventions to Manage Food Intake: Where Are We Now?
Allman-Farinelli, M. A., & Gemming, L. (2017) · Current Diabetes Reports · doi:10.1007/s11892-017-0937-5 · Cited by 21
Gherman, A., Andrei, D., Popoiu, C. M., Stoicescu, E. R., Levai, M. C., Stoian, I. I., & Bloancă, V. (2025) · Life · doi:10.3390/life15050783 · Cited by 19
“Telemedicine has been shown in studies to assist diabetes mellitus (DM) care by improving glucose parameters [105,106], increasing patient participation and provider satisfaction [107].”
Metadata
- Authors
- Faruque, L. I., Wiebe, N., Ehteshami-Afshar, A., Liu, Y., Dianati-Maleki, N., Hemmelgarn, B. R., Manns, B. J., & Tonelli, M.
- Affiliations
- University of Alberta (CA)
- Venue
- Canadian Medical Association Journal
- Publisher
- CMA Impact Inc.
- Published
- 2016-10-31
- Volume
- 189
- Issue
- 9
- Pages
- E341-E364
- ISSN
- 0820-3946 (ISSN-L)
- 1488-2329
- PMC
- PMC5334006
- OpenAlex
- W2546067499
- Cited by
- 281
- References
- 187
- Citations by year
- 2026: 14 · 2025: 25 · 2024: 33 · 2023: 29 · 2022: 46 · 2021: 46 · 2020: 32 · 2019: 25 · 2018: 18 · 2017: 12 · 2016: 1
- FWCI
- 2.76
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Canadian Medical Association Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- telemedicine, diabetes mellitus, HbA1c, glycemic control, diabetes management, web portal, text messaging, medication adjustment, quality of life, hypoglycemia, mortality
- MeSH terms
- Communication, Diabetes Mellitus, Glycated Hemoglobin, Humans, Hypoglycemia, Quality of Life, Randomized Controlled Trials as Topic, Telemedicine, Disease Management, Internet, Text Messaging
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