The Longitudinal Epidemiologic Assessment of Diabetes Risk (LEADR): Unique 1.4 M patient Electronic Health Record cohort.


Journal

Healthcare (Amsterdam, Netherlands)
ISSN: 2213-0772
Titre abrégé: Healthc (Amst)
Pays: Netherlands
ID NLM: 101622189

Informations de publication

Date de publication:
Dec 2020
Historique:
received: 02 12 2019
revised: 17 06 2020
accepted: 27 07 2020
pubmed: 5 10 2020
medline: 30 6 2021
entrez: 4 10 2020
Statut: ppublish

Résumé

The Longitudinal Epidemiologic Assessment of Diabetes Risk (LEADR) study uses a novel Electronic Health Record (EHR) data approach as a tool to assess the epidemiology of known and new risk factors for type 2 diabetes mellitus (T2DM) and study how prevention interventions affect progression to and onset of T2DM. We created an electronic cohort of 1.4 million patients having had at least 4 encounters with a healthcare organization for at least 24-months; were aged ≥18 years in 2010; and had no diabetes (i.e., T1DM or T2DM) at cohort entry or in the 12 months following entry. EHR data came from patients at nine healthcare organizations across the U.S. between January 1, 2010-December 31, 2016. Approximately 5.9% of the LEADR cohort (82,922 patients) developed T2DM, providing opportunities to explore longitudinal clinical care, medication use, risk factor trajectories, and diagnoses for these patients, compared with patients similarly matched prior to disease onset. LEADR represents one of the largest EHR databases to have repurposed EHR data to examine patients' T2DM risk. This paper is first in a series demonstrating this novel approach to studying T2DM. Chronic conditions that often take years to develop can be studied efficiently using EHR data in a retrospective design. While much is already known about T2DM risk, this EHR's cohort's 160 M data points for 1.4 M people over six years, provides opportunities to investigate new unique risk factors and evaluate research hypotheses where results could modify public health practice for preventing T2DM.

Sections du résumé

BACKGROUND BACKGROUND
The Longitudinal Epidemiologic Assessment of Diabetes Risk (LEADR) study uses a novel Electronic Health Record (EHR) data approach as a tool to assess the epidemiology of known and new risk factors for type 2 diabetes mellitus (T2DM) and study how prevention interventions affect progression to and onset of T2DM. We created an electronic cohort of 1.4 million patients having had at least 4 encounters with a healthcare organization for at least 24-months; were aged ≥18 years in 2010; and had no diabetes (i.e., T1DM or T2DM) at cohort entry or in the 12 months following entry. EHR data came from patients at nine healthcare organizations across the U.S. between January 1, 2010-December 31, 2016.
RESULTS RESULTS
Approximately 5.9% of the LEADR cohort (82,922 patients) developed T2DM, providing opportunities to explore longitudinal clinical care, medication use, risk factor trajectories, and diagnoses for these patients, compared with patients similarly matched prior to disease onset.
CONCLUSIONS CONCLUSIONS
LEADR represents one of the largest EHR databases to have repurposed EHR data to examine patients' T2DM risk. This paper is first in a series demonstrating this novel approach to studying T2DM.
IMPLICATIONS CONCLUSIONS
Chronic conditions that often take years to develop can be studied efficiently using EHR data in a retrospective design.
LEVEL OF EVIDENCE METHODS
While much is already known about T2DM risk, this EHR's cohort's 160 M data points for 1.4 M people over six years, provides opportunities to investigate new unique risk factors and evaluate research hypotheses where results could modify public health practice for preventing T2DM.

Identifiants

pubmed: 33011645
pii: S2213-0764(20)30057-9
doi: 10.1016/j.hjdsi.2020.100458
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

100458

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

Auteurs

Howard A Fishbein (HA)

Westat, Rockville, MD, USA. Electronic address: HowardFishbein@westat.com.

Rebecca Jeffries Birch (RJ)

Westat, Rockville, MD, USA.

Sunitha M Mathew (SM)

Westat, Rockville, MD, USA.

Holly L Sawyer (HL)

Westat, Rockville, MD, USA.

Gerald Pulver (G)

University of Colorado Anschutz Medical Campus, Denver, CO, USA.

Jennifer Poling (J)

Cherokee Health Systems Inc, Knoxville, TN, USA.

David Kaelber (D)

The MetroHealth System and Case Western Reserve University, Cleveland, OH, USA.

Russell Mardon (R)

Westat, Rockville, MD, USA.

Maurice C Johnson (MC)

Westat, Rockville, MD, USA.

Wilson Pace (W)

DARTNet, Aurora, CO, USA.

Keith D Umbel (KD)

Westat, Rockville, MD, USA.

Xuanping Zhang (X)

Centers for Disease Control and Prevention, Division of Diabetes Translation, Atlanta, GA, USA.

Karen R Siegel (KR)

Centers for Disease Control and Prevention, Division of Diabetes Translation, Atlanta, GA, USA.

Giuseppina Imperatore (G)

Centers for Disease Control and Prevention, Division of Diabetes Translation, Atlanta, GA, USA.

Sundar Shrestha (S)

Centers for Disease Control and Prevention, Division of Diabetes Translation, Atlanta, GA, USA.

Krista Proia (K)

Centers for Disease Control and Prevention, Division of Diabetes Translation, Atlanta, GA, USA.

Yiling Cheng (Y)

Centers for Disease Control and Prevention, Division of Diabetes Translation, Atlanta, GA, USA.

Kai McKeever Bullard (K)

Centers for Disease Control and Prevention, Division of Diabetes Translation, Atlanta, GA, USA.

Edward W Gregg (EW)

Centers for Disease Control and Prevention, Division of Diabetes Translation, Atlanta, GA, USA.

Deborah Rolka (D)

Centers for Disease Control and Prevention, Division of Diabetes Translation, Atlanta, GA, USA.

Meda E Pavkov (ME)

Centers for Disease Control and Prevention, Division of Diabetes Translation, Atlanta, GA, USA.

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Classifications MeSH