Building a multistate model from electronic health records data for modeling long-term diabetes complications
Date
2024-09-23
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of Clinical and Translational Science
Abstract
Objective:
The progression of long-term diabetes complications has led to a decreased quality of life. Our objective was to evaluate the adverse outcomes associated with diabetes based on a patient’s clinical profile by utilizing a multistate modeling approach.
Methods:
This was a retrospective study of diabetes patients seen in primary care practices from 2013 to 2017. We implemented a five-state model to examine the progression of patients transitioning from one complication to having multiple complications. Our model incorporated high dimensional covariates from multisource data to investigate the possible effects of different types of factors that are associated with the progression of diabetes.
Results:
The cohort consisted of 10,596 patients diagnosed with diabetes and no previous complications associated with the disease. Most of the patients in our study were female, White, and had type 2 diabetes. During our study period, 5928 did not develop complications, 3323 developed microvascular complications, 1313 developed macrovascular complications, and 1129 developed both micro- and macrovascular complications. From our model, we determined that patients had a 0.1334 [0.1284, .1386] rate of developing a microvascular complication compared to 0.0508 [0.0479, .0540] rate of developing a macrovascular complication. The area deprivation index score we incorporated as a proxy for socioeconomic information indicated that patients who reside in more disadvantaged areas have a higher rate of developing a complication compared to those who reside in least disadvantaged areas.
Conclusions:
Our work demonstrates how a multistate modeling framework is a comprehensive approach to analyzing the progression of long-term complications associated with diabetes.
Description
This article was originally published in Journal of Clinical and Translational Science. The version of record is available at: https://doi.org/10.1017/cts.2024.583.
© The Author(s), 2024. Published by Cambridge University Press on behalf of Association for Clinical and Translational Science.
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-ShareAlike licence (http://creativecommons.org/licenses/by-sa/4.0/), which permits re-use, distribution, and reproduction in any medium, provided the same Creative Commons licence is used to distribute the re-used or adapted article and the original article is properly cited.
Keywords
diabetes, electronic health records, multistate modeling, diabetes complications, transition probability
Citation
Li, Riza C., Shanshan Ding, Kevin Ndura, Vishal Patel, and Claudine Jurkovitz. “Building a Multistate Model from Electronic Health Records Data for Modeling Long-Term Diabetes Complications.” Journal of Clinical and Translational Science 8, no. 1 (2024): e133. https://doi.org/10.1017/cts.2024.583.