Effectiveness of a targeted primary preventive intervention in a high-risk group identified using an efficiency score from data envelopment analysis: a randomised controlled trial of local residents in Japan
ObjectiveTo determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents hypertension.DesignRandomised controlled trial.SettingTakahata town (Yamagata, Japan).ParticipantsResidents aged 40–74 years belonged to the information...
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| Published in | BMJ open Vol. 13; no. 5; p. e070187 |
|---|---|
| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
British Medical Journal Publishing Group
16.05.2023
BMJ Publishing Group LTD BMJ Publishing Group |
| Series | Original research |
| Subjects | |
| Online Access | Get full text |
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| Abstract | ObjectiveTo determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents hypertension.DesignRandomised controlled trial.SettingTakahata town (Yamagata, Japan).ParticipantsResidents aged 40–74 years belonged to the information provision group for specific health guidance. Participants with a blood pressure ≥140/90 mm Hg, those taking antihypertensive medication, or those with a history of cardiac diseases were excluded. Participants were consecutively assigned based on their health check-up visit at a single centre from September 2019 to November 2020 and were followed up at the check-up in the following year, until 3 December 2021.InterventionA targeted approach using minimal intervention. Target was identified using DEA and 50% of participants with higher risk were targeted. The intervention was notifying the results of their risk of hypertension according to the efficiency score obtained by the DEA.Primary outcome measuresA reduction in the proportion of participants who developed hypertension (≥140/90 mm Hg or taking antihypertensive medication).ResultsA total of 495 eligible participants were randomised, and follow-up data were available for 218 and 227 participants in the intervention and control groups, respectively. The risk difference for the primary outcome was 0.2% (95% CI −7.3 to 6.9) with 38/218 (17.4%) and 40/227 (17.6%) events in the intervention and control group, respectively (Pearson’s χ2 test, p=0.880). The adjusted OR of the effect of the intervention was 0.95 (95% CI 0.56 to 1.61, p=0.843), and that of the efficiency score (10-rank increase) was 0.81 (95% CI 0.74 to 0.89, p<0.0001).ConclusionsMinimal intervention to a high-risk population stratified by DEA was not effective in reducing the onset of hypertension in 1 year. The efficiency score could predict the risk of hypertension.Trial registration numberUMIN000037883 |
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| AbstractList | Objective To determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents hypertension.Design Randomised controlled trial.Setting Takahata town (Yamagata, Japan).Participants Residents aged 40–74 years belonged to the information provision group for specific health guidance. Participants with a blood pressure ≥140/90 mm Hg, those taking antihypertensive medication, or those with a history of cardiac diseases were excluded. Participants were consecutively assigned based on their health check-up visit at a single centre from September 2019 to November 2020 and were followed up at the check-up in the following year, until 3 December 2021.Intervention A targeted approach using minimal intervention. Target was identified using DEA and 50% of participants with higher risk were targeted. The intervention was notifying the results of their risk of hypertension according to the efficiency score obtained by the DEA.Primary outcome measures A reduction in the proportion of participants who developed hypertension (≥140/90 mm Hg or taking antihypertensive medication).Results A total of 495 eligible participants were randomised, and follow-up data were available for 218 and 227 participants in the intervention and control groups, respectively. The risk difference for the primary outcome was 0.2% (95% CI −7.3 to 6.9) with 38/218 (17.4%) and 40/227 (17.6%) events in the intervention and control group, respectively (Pearson’s χ2 test, p=0.880). The adjusted OR of the effect of the intervention was 0.95 (95% CI 0.56 to 1.61, p=0.843), and that of the efficiency score (10-rank increase) was 0.81 (95% CI 0.74 to 0.89, p<0.0001).Conclusions Minimal intervention to a high-risk population stratified by DEA was not effective in reducing the onset of hypertension in 1 year. The efficiency score could predict the risk of hypertension.Trial registration number UMIN000037883 ObjectiveTo determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents hypertension.DesignRandomised controlled trial.SettingTakahata town (Yamagata, Japan).ParticipantsResidents aged 40–74 years belonged to the information provision group for specific health guidance. Participants with a blood pressure ≥140/90 mm Hg, those taking antihypertensive medication, or those with a history of cardiac diseases were excluded. Participants were consecutively assigned based on their health check-up visit at a single centre from September 2019 to November 2020 and were followed up at the check-up in the following year, until 3 December 2021.InterventionA targeted approach using minimal intervention. Target was identified using DEA and 50% of participants with higher risk were targeted. The intervention was notifying the results of their risk of hypertension according to the efficiency score obtained by the DEA.Primary outcome measuresA reduction in the proportion of participants who developed hypertension (≥140/90 mm Hg or taking antihypertensive medication).ResultsA total of 495 eligible participants were randomised, and follow-up data were available for 218 and 227 participants in the intervention and control groups, respectively. The risk difference for the primary outcome was 0.2% (95% CI −7.3 to 6.9) with 38/218 (17.4%) and 40/227 (17.6%) events in the intervention and control group, respectively (Pearson’s χ2 test, p=0.880). The adjusted OR of the effect of the intervention was 0.95 (95% CI 0.56 to 1.61, p=0.843), and that of the efficiency score (10-rank increase) was 0.81 (95% CI 0.74 to 0.89, p<0.0001).ConclusionsMinimal intervention to a high-risk population stratified by DEA was not effective in reducing the onset of hypertension in 1 year. The efficiency score could predict the risk of hypertension.Trial registration numberUMIN000037883 OBJECTIVETo determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents hypertension. DESIGNRandomised controlled trial. SETTINGTakahata town (Yamagata, Japan). PARTICIPANTSResidents aged 40-74 years belonged to the information provision group for specific health guidance. Participants with a blood pressure ≥140/90 mm Hg, those taking antihypertensive medication, or those with a history of cardiac diseases were excluded. Participants were consecutively assigned based on their health check-up visit at a single centre from September 2019 to November 2020 and were followed up at the check-up in the following year, until 3 December 2021. INTERVENTIONA targeted approach using minimal intervention. Target was identified using DEA and 50% of participants with higher risk were targeted. The intervention was notifying the results of their risk of hypertension according to the efficiency score obtained by the DEA. PRIMARY OUTCOME MEASURESA reduction in the proportion of participants who developed hypertension (≥140/90 mm Hg or taking antihypertensive medication). RESULTSA total of 495 eligible participants were randomised, and follow-up data were available for 218 and 227 participants in the intervention and control groups, respectively. The risk difference for the primary outcome was 0.2% (95% CI -7.3 to 6.9) with 38/218 (17.4%) and 40/227 (17.6%) events in the intervention and control group, respectively (Pearson's χ2 test, p=0.880). The adjusted OR of the effect of the intervention was 0.95 (95% CI 0.56 to 1.61, p=0.843), and that of the efficiency score (10-rank increase) was 0.81 (95% CI 0.74 to 0.89, p<0.0001). CONCLUSIONSMinimal intervention to a high-risk population stratified by DEA was not effective in reducing the onset of hypertension in 1 year. The efficiency score could predict the risk of hypertension. TRIAL REGISTRATION NUMBERUMIN000037883. Objective To determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents hypertension. Design Randomised controlled trial. Setting Takahata town (Yamagata, Japan). Participants Residents aged 40–74 years belonged to the information provision group for specific health guidance. Participants with a blood pressure ≥140/90 mm Hg, those taking antihypertensive medication, or those with a history of cardiac diseases were excluded. Participants were consecutively assigned based on their health check-up visit at a single centre from September 2019 to November 2020 and were followed up at the check-up in the following year, until 3 December 2021. Intervention A targeted approach using minimal intervention. Target was identified using DEA and 50% of participants with higher risk were targeted. The intervention was notifying the results of their risk of hypertension according to the efficiency score obtained by the DEA. Primary outcome measures A reduction in the proportion of participants who developed hypertension (≥140/90 mm Hg or taking antihypertensive medication). Results A total of 495 eligible participants were randomised, and follow-up data were available for 218 and 227 participants in the intervention and control groups, respectively. The risk difference for the primary outcome was 0.2% (95% CI −7.3 to 6.9) with 38/218 (17.4%) and 40/227 (17.6%) events in the intervention and control group, respectively (Pearson’s χ 2 test, p=0.880). The adjusted OR of the effect of the intervention was 0.95 (95% CI 0.56 to 1.61, p=0.843), and that of the efficiency score (10-rank increase) was 0.81 (95% CI 0.74 to 0.89, p<0.0001). Conclusions Minimal intervention to a high-risk population stratified by DEA was not effective in reducing the onset of hypertension in 1 year. The efficiency score could predict the risk of hypertension. Trial registration number UMIN000037883 To determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents hypertension. Randomised controlled trial. Takahata town (Yamagata, Japan). Residents aged 40-74 years belonged to the information provision group for specific health guidance. Participants with a blood pressure ≥140/90 mm Hg, those taking antihypertensive medication, or those with a history of cardiac diseases were excluded. Participants were consecutively assigned based on their health check-up visit at a single centre from September 2019 to November 2020 and were followed up at the check-up in the following year, until 3 December 2021. A targeted approach using minimal intervention. Target was identified using DEA and 50% of participants with higher risk were targeted. The intervention was notifying the results of their risk of hypertension according to the efficiency score obtained by the DEA. A reduction in the proportion of participants who developed hypertension (≥140/90 mm Hg or taking antihypertensive medication). A total of 495 eligible participants were randomised, and follow-up data were available for 218 and 227 participants in the intervention and control groups, respectively. The risk difference for the primary outcome was 0.2% (95% CI -7.3 to 6.9) with 38/218 (17.4%) and 40/227 (17.6%) events in the intervention and control group, respectively (Pearson's χ test, p=0.880). The adjusted OR of the effect of the intervention was 0.95 (95% CI 0.56 to 1.61, p=0.843), and that of the efficiency score (10-rank increase) was 0.81 (95% CI 0.74 to 0.89, p<0.0001). Minimal intervention to a high-risk population stratified by DEA was not effective in reducing the onset of hypertension in 1 year. The efficiency score could predict the risk of hypertension. UMIN000037883. |
| Author | Togashi, Masanori Izumiya, Ken Yamada, Emiko Narimatsu, Hiroto Kanda, Satoru Ogawa, Iku Inoue, Rina Kido, Miki Nakamura, Sho Endo, Hiroko Sato, Shoko |
| AuthorAffiliation | 3 CIKOP, Specified Nonprofit Corporation , Yamagata , Yamagata , Japan 7 Division of Urology , Takahata Public Hospital , Takahata, Higashiokitama-gun , Yamagata , Japan 1 Graduate School of Health Innovation , Kanagawa University of Human Services , Kawasaki , Kanagawa , Japan 4 Office of Health Policy, Department of Health and Welfare , Iwate Prefectural Government Office , Morioka , Iwate , Japan 2 Cancer Prevention and Control Division , Kanagawa Cancer Center Research Institute , Yokohama , Kanagawa , Japan 8 Department of Genetic Medicine , Kanagawa Cancer Center , Yokohama , Kanagawa , Japan 6 Section of Health and Longevity Service , Takahata Town Office , Takahata, Higashiokitama-gun , Yamagata , Japan 5 Section of Welfare and Child Service , Takahata Town Office , Takahata, Higashiokitama-gun , Yamagata , Japan |
| AuthorAffiliation_xml | – name: 4 Office of Health Policy, Department of Health and Welfare , Iwate Prefectural Government Office , Morioka , Iwate , Japan – name: 3 CIKOP, Specified Nonprofit Corporation , Yamagata , Yamagata , Japan – name: 1 Graduate School of Health Innovation , Kanagawa University of Human Services , Kawasaki , Kanagawa , Japan – name: 7 Division of Urology , Takahata Public Hospital , Takahata, Higashiokitama-gun , Yamagata , Japan – name: 5 Section of Welfare and Child Service , Takahata Town Office , Takahata, Higashiokitama-gun , Yamagata , Japan – name: 2 Cancer Prevention and Control Division , Kanagawa Cancer Center Research Institute , Yokohama , Kanagawa , Japan – name: 6 Section of Health and Longevity Service , Takahata Town Office , Takahata, Higashiokitama-gun , Yamagata , Japan – name: 8 Department of Genetic Medicine , Kanagawa Cancer Center , Yokohama , Kanagawa , Japan |
| Author_xml | – sequence: 1 givenname: Sho orcidid: 0000-0002-5378-9477 surname: Nakamura fullname: Nakamura, Sho email: research@nakasho.org organization: CIKOP, Specified Nonprofit Corporation, Yamagata, Yamagata, Japan – sequence: 2 givenname: Satoru surname: Kanda fullname: Kanda, Satoru organization: Office of Health Policy, Department of Health and Welfare, Iwate Prefectural Government Office, Morioka, Iwate, Japan – sequence: 3 givenname: Hiroko surname: Endo fullname: Endo, Hiroko organization: Section of Welfare and Child Service, Takahata Town Office, Takahata, Higashiokitama-gun, Yamagata, Japan – sequence: 4 givenname: Emiko surname: Yamada fullname: Yamada, Emiko organization: Section of Health and Longevity Service, Takahata Town Office, Takahata, Higashiokitama-gun, Yamagata, Japan – sequence: 5 givenname: Miki surname: Kido fullname: Kido, Miki organization: Section of Health and Longevity Service, Takahata Town Office, Takahata, Higashiokitama-gun, Yamagata, Japan – sequence: 6 givenname: Shoko surname: Sato fullname: Sato, Shoko organization: Section of Health and Longevity Service, Takahata Town Office, Takahata, Higashiokitama-gun, Yamagata, Japan – sequence: 7 givenname: Iku surname: Ogawa fullname: Ogawa, Iku organization: Section of Health and Longevity Service, Takahata Town Office, Takahata, Higashiokitama-gun, Yamagata, Japan – sequence: 8 givenname: Rina surname: Inoue fullname: Inoue, Rina organization: CIKOP, Specified Nonprofit Corporation, Yamagata, Yamagata, Japan – sequence: 9 givenname: Masanori surname: Togashi fullname: Togashi, Masanori organization: Section of Health and Longevity Service, Takahata Town Office, Takahata, Higashiokitama-gun, Yamagata, Japan – sequence: 10 givenname: Ken surname: Izumiya fullname: Izumiya, Ken organization: Division of Urology, Takahata Public Hospital, Takahata, Higashiokitama-gun, Yamagata, Japan – sequence: 11 givenname: Hiroto orcidid: 0000-0002-0383-4911 surname: Narimatsu fullname: Narimatsu, Hiroto organization: Department of Genetic Medicine, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37192789$$D View this record in MEDLINE/PubMed |
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doi: 10.1152/physiolgenomics.00032.2017 |
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| Snippet | ObjectiveTo determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents... To determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents hypertension.... Objective To determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents... OBJECTIVETo determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents... Objective To determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents... |
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| SubjectTerms | Angina pectoris Antihypertensive Agents - therapeutic use Antihypertensives Blood pressure Blood Pressure - physiology Creatinine Data envelopment analysis Disease prevention Efficiency Epidemiology Health risk assessment Heart attacks Humans Hypertension Hypertension - drug therapy Hypertension - prevention & control Intervention Japan Linear programming preventive medicine Risk Factors risk management Salt |
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| Title | Effectiveness of a targeted primary preventive intervention in a high-risk group identified using an efficiency score from data envelopment analysis: a randomised controlled trial of local residents in Japan |
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