Assessing the Burden of Diabetes by Type in Children, Adolescents and Young Adults (DiCAYA) - Component B (18 to < 45 yrs)

按类型评估儿童、青少年和年轻人的糖尿病负担 (DiCAYA) - B 部分（18 岁至 < 45 岁）

• 批准号: 10636654
• 负责人: Kristi Reynolds
• 金额: $ 25万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10636654
• 关键词: Assessing; Burden; Diabetes; Type; Children

Project Summary Diabetes, a spectrum of metabolic diseases caused by deficits in insulin secretion, insulin action, or both, is one of the most common chronic diseases among adults, effecting over 30 million people in the United States in 2017. Using data from the National Health Interview Survey (NHIS), the CDC estimated that young adults ages 18-44 years account for ~ 3 million diagnosed diabetes cases and 1.6 million undiagnosed cases in the US in 2015, with 3.1/1,000 individuals in this age group developing diabetes each year. NHIS results are based on self-report of diagnosis date, insulin use, and diabetes type, which may not accurately assess diabetes status and type. In 2017, the Diabetes in Young Adult (DiYA) study estimated that the age- and sex- standardized diabetes incidence rate was 3.8/1,000 using information in electronic health records (EHR) of a racially/ethnically diverse population of over 2.1 million health plan members 18-44 years in California. Given that the incidence and prevalence of diabetes in US children and adolescents < 18 years continues to increase and there is minimal mortality among this age group, these increases will in part drive increases in prevalence of diabetes in young adults. A major challenge of diabetes surveillance in this age group is that most reported estimates of incidence and prevalence are not type-specific. Use of electronic health records (EHRs) allow for the assessment of type based on clinicians' determination and provides other clinical and demographic information such as pharmacological treatment, body mass index, age and race/ethnicity. The Aims of this study are: Aim 1: To ascertain prevalent diabetes cases in calendar years 2020-2024 among young adults ages 18-44 years at diagnosis, using cost-efficient approaches that maximize use of information in the electronic health records (EHRs) and administrative databases. Aim 2: To ascertain newly diagnosed (incident 2020-2024) diabetes cases in young adults ages 18-44 years, using cost-efficient approaches that maximize use of EHRs and administrative data. Aim 3: To describe selected clinical characteristics at diagnosis and determine if these characteristics have changed over time. This study will be conducted in Kaiser Permanente Southern California (KPSC), an integrated health care system that has ~1.4 million members age 18-44 years in an 8-county area including Los Angeles county, the largest county in California. The racial/ethnic diversity of the membership, the wealth of clinical information in the EHR including diagnosis codes from inpatient, outpatient, and virtual care encounters; laboratory test results including diabetes autoantibodies (when ordered); dispensed prescriptions, height, weight, blood pressure, and patient reported outcomes that can be linked to demographic and membership data including health plan enrollment start and end dates, creates a robust platform for diabetes surveillance activities.

项目摘要 糖尿病，一种由胰岛素分泌不足或胰岛素作用不足或两者兼而有之而引起的代谢性疾病 成人中最常见的慢性病之一，影响着美国3000多万人 2017年。利用国家健康访谈调查(NHIS)的数据，疾控中心估计，年轻人 在中国，18-44岁的人中约有300万确诊糖尿病病例和160万未确诊病例 2015年，这个年龄段的人中每年有3.1/1000人患上糖尿病。NHIS结果基于 关于诊断日期、胰岛素使用和糖尿病类型的自我报告，这些可能不能准确评估糖尿病 状态和类型。2017年，青年糖尿病(Diya)研究估计，年龄和性别- 使用电子健康记录(EHR)中的信息，标准化糖尿病发病率为3.8/1000 在加利福尼亚州，18-44岁的种族/民族多样化人口超过210万健康计划成员。vt.给出 美国18岁儿童和青少年中糖尿病的发病率和流行率继续上升 在这个年龄段中死亡率很低，这些增加将在一定程度上推动患病率的增加 年轻人患糖尿病的风险。在这个年龄段进行糖尿病监测的一个主要挑战是，大多数报告 对发病率和流行率的估计不是特定类型的。电子健康记录(EHR)的使用允许 根据临床医生的决定进行的类型评估，并提供其他临床和人口统计信息 例如药物治疗、体重指数、年龄和种族/民族等信息。这样做的目的是 研究内容为：目标1：确定2020-2024年青壮年糖尿病流行病例 年龄在18-44岁之间，使用经济高效的方法最大限度地利用信息 电子健康记录(EHR)和行政数据库。目标2：确定新诊断 (事件2020-2024)18-44岁年轻人中的糖尿病病例，使用具有成本效益的方法 最大限度地利用电子病历和管理数据。目标3：描述选定的临床特征 诊断并确定这些特征是否随着时间的推移而改变。这项研究将在 Kaiser Permanente Southern California(KPSC)，这是一个集成的医疗保健系统，拥有约140万 成员年龄在18-44岁之间，包括加利福尼亚州最大的县洛杉矶县在内的8个县区。 成员的种族/民族多样性，电子病历中丰富的临床信息，包括诊断 来自住院、门诊和虚拟护理的代码；包括糖尿病在内的实验室检测结果 自身抗体(订购时)；处方、身高、体重、血压和报告的患者 可与人口统计和会员数据相关联的结果，包括健康计划登记开始和 结束日期，为糖尿病监测活动创建了一个强大的平台。