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Author Notes:

Karla I. Galaviz

Hubert Department of Global Health, Rollins School of Public Health, Emory University, #1518 Clifton Rd, Atlanta, GA 30322, CNR Building Room 7040.

Tel: 404-202-5802

kgalavi@emory.edu

Authors declare no competing interests.

Subject:

Research Funding:

This project was funded by the Disease Control Priorities Network grant to the Institute for Health Metrics and Evaluation from the Bill & Melinda Gates Foundation (UWSC7007). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Authors KIG, MKA, KVN and MBW were partially supported by the Georgia Center for Diabetes Translation Research (P30DK111024).

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Endocrinology & Metabolism
  • Effectiveness metrics
  • Implementation science
  • Global health
  • LIFE-STYLE INTERVENTIONS
  • DIABETES PREVENTION
  • PROMOTION PROGRAMS
  • TRANSLATION
  • METAANALYSIS
  • GUIDELINE

The Estimating effectiveness from efficacy taxonomy (EFFECT): A tool to estimate the real-world impact of health interventions

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Journal Title:

DIABETES RESEARCH AND CLINICAL PRACTICE

Volume:

Volume 159

Publisher:

, Pages 107751-107751

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Aims: To develop and pilot test a taxonomy that empirically estimates health intervention effectiveness from efficacy data. Methods: We developed a taxonomy to score health interventions across 11 items on a scale from 0–100. The taxonomy was pilot-tested in efficacy and effectiveness diabetes prevention studies identified in two separate systematic reviews; here, the face validity, inter-rater reliability and factor structure of the taxonomy were established. Random effects meta-analyses were used to obtain weight loss and diabetes incidence pooled effects across studies. These effects and taxonomy scores were used to down calibrate efficacy estimates to effectiveness estimates as follows: Efficacy effect*[Efficacy score/highest possible score]. Results: We scored 82 effectiveness lifestyle modification studies (mean score 49.2), 32 efficacy lifestyle modification studies (mean score 69.8) and 20 efficacy studies testing medications (mean score 77.4). The taxonomy had face validity and good inter-rater reliability (ICC = 0.9 [0.87, 0.93]). The between-groups down calibrated weight loss estimate was similar to that observed in the effectiveness meta-analysis (1.7 and 1.8 kg, respectively). The down calibrated diabetes relative risk reduction was also similar to that observed in the effectiveness meta-analysis (30.6% over 2.7 years and 29% over 2 years, respectively). Conclusions: The taxonomy is a promising tool to estimate the real-world impact of health interventions.

Copyright information:

2019

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/rdf).
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