Population-level management of type 1 diabetes via continuous glucose monitoring and algorithm-enabled patient prioritization: Precision health meets population health.
Population-level management of type 1 diabetes via continuous glucose monitoring and algorithm-enabled patient prioritization: Precision health meets population health.
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DOI：
10.1111/pedi.13256
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发表时间：
2021-11
影响因子：
3.4
通讯作者：
Scheinker D
中科院分区：
文献类型：
--
作者：
Ferstad JO;Vallon JJ;Jun D;Gu A;Vitko A;Morales DP;Leverenz J;Lee MY;Leverenz B;Vasilakis C;Osmanlliu E;Prahalad P;Maahs DM;Johari R;Scheinker D
开发和扩展算法支持的患者优先级，以改善具有固定资源的儿科诊所中1型糖尿病（T1 D）的人群水平管理，使用远程医疗和通过动态血糖监测仪（CGM）数据审查对患者进行远程监测。我们使用CGM调整了T1 D患者的共识血糖目标，以确定可解释的临床标准，从而优先考虑患者进行每周提供者审查。该标准旨在管理每周接受审查的患者数量，并确定最需要与提供者联系的患者。我们开发了一个交互式仪表板，以显示与优先审查的患者相关的CGM数据。新标准和交互式仪表板的引入使糖尿病团队成员远程异步审查患者数据和联系患者的平均时间减少了60%，从每周每位患者的3.2 ± 0.20分钟减少到1.3 ± 0.24分钟。考虑到审查的固定资源，这相当于每周诊所能力估计增加147%。与T1 D发作后12个月时不符合条件的25例对照患者相比，符合条件并接受远程审查的患者（n = 58）的葡萄糖在范围内的时间（70-180 mg/dl）增加了8.8个百分点（pp）（95% CI = 0.6-16.9 pp）。一种算法使能的T1 D患者CGM异步远程审查优先级减少了每位患者花费的提供者时间，并与改善的范围内时间相关。
To develop and scale algorithm-enabled patient prioritization to improve population-level management of type 1 diabetes (T1D) in a pediatric clinic with fixed resources, using telemedicine and remote monitoring of patients via continuous glucose monitor (CGM) data review. We adapted consensus glucose targets for T1D patients using CGM to identify interpretable clinical criteria to prioritize patients for weekly provider review. The criteria were constructed to manage the number of patients reviewed weekly and identify patients who most needed provider contact. We developed an interactive dashboard to display CGM data relevant for the patients prioritized for review. The introduction of the new criteria and interactive dashboard was associated with a 60% reduction in the mean time spent by diabetes team members who remotely and asynchronously reviewed patient data and contacted patients, from 3.2 ± 0.20 to 1.3 ± 0.24 min per patient per week. Given fixed resources for review, this corresponded to an estimated 147% increase in weekly clinic capacity. Patients who qualified for and received remote review (n = 58) have associated 8.8 percentage points (pp) (95% CI = 0.6–16.9 pp) greater time-in-range (70–180 mg/dl) glucoses compared to 25 control patients who did not qualify at 12 months after T1D onset. An algorithm-enabled prioritization of T1D patients with CGM for asynchronous remote review reduced provider time spent per patient and was associated with improved time-in-range.
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影响因子：
5.4
作者：
Phillip, Moshe;Bergenstal, Richard M.;Battelino, Tadej
通讯作者：
Battelino, Tadej
影响因子：
5
作者：
Fonda, Stephanie J;Graham, Claudia;Vigersky, Robert A
通讯作者：
Vigersky, Robert A
影响因子：
5.8
作者：
Nimri, Revital;Dassau, Eyal;Phillip, Moshe
通讯作者：
Phillip, Moshe
DOI：
10.9778/cmajo.20170022
发表时间：
2017-07-24
期刊：
CMAJ open
影响因子：
--
作者：
Nakhla, Meranda;Rahme, Elham;Guttmann, Astrid
通讯作者：
Guttmann, Astrid
影响因子：
16.2
作者：
Battelino, Tadej;Danne, Thomas;Phillip, Moshe
通讯作者：
Phillip, Moshe