Severity domains for quantifying the severity of Type 2 diabetes using primary care data and linked hospitalisation records from England

ZGHEBI, SS; Rutter, MK; Ashcroft, DM; Van Marwijk, H; Mallen, Christian; Chew-Graham, Carolyn A; Qureshi, N; Weng, S; Mamas, Mamas; Kontopantelis, E

Abstract

Aims: Despite the increasing prevalence of Type 2 diabetes, which presents a significant burden on healthcare resources, there is no agreed validated UK measure to infer Type 2 diabetes severity from electronic health records (EHRs). This study aimed to identify important clinical severity domains, recorded in EHRs, which could be used to quantify the severity of Type 2 diabetes.

Methods: Data from the Clinical Practice Research Datalink (CPRD) and hospitalisation records for people with Type 2 diabetes, registered with linked English general practices, to be used to develop a clinical decision algorithm to grade diabetes severity between 2006 and 2016. At this stage of the study, we have identified clinically relevant severity domains (main risk factors for adverse outcomes) to be incorporated in the severity algorithm.

Results: The main severity domains for Type 2 diabetes identified through a systematic review and expert opinion include age, diabetes duration, HbA1c, hypoglycaemia, microvascular complications, cardiovascular (CV) disease (heart failure, coronary heart disease, revascularisation interventions), cerebrovascular disease, renal disease, patterns of prescribed antidiabetic and cardiovascular treatments, hospital admissions (any-cause, diabetes-related and CV disease-related admissions).

Summary: All identified severity domains, recorded in routinely collected real-world EHRs, are clinically relevant in our work to define the severity of Type 2 diabetes. This first step forms a platform on which to develop the severity tool, which will be informative to practitioners, could stratify clinical management of people with Type 2 diabetes, support commissioning and public health programmes and inform the methodology of measuring the severity of other chronic conditions managed in primary care.

Contribution was also made by the following additional authors: C Salisbury, School of Social and Community Medicine, University of Bristol, Bristol, UK; D Reeves: Centre for Primary Care, University of Manchester, Manchester, UK; T Holt, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; P Rafael, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; I Buchan, Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester, UK and N Peek, Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester, UK

Citation

ZGHEBI, S., Rutter, M., Ashcroft, D., Van Marwijk, H., Mallen, C., Chew-Graham, C. A., Qureshi, N., Weng, S., Mamas, M., & Kontopantelis, E. (2018, March). Severity domains for quantifying the severity of Type 2 diabetes using primary care data and linked hospitalisation records from England. Poster presented at Diabetes UK Professional Conference 2018, London ExCeL, London, UK

• Presentation Conference Type: Poster
• Conference Name: Diabetes UK Professional Conference 2018
• Start Date: Mar 14, 2018
• End Date: Mar 16, 2018
• Deposit Date: Jun 27, 2023
• Public URL: https://keele-repository.worktribe.com/output/508984