Evaluation of the HealthImpact Diabetes Risk Model in the Veterans Health Administration

Journal of Managed Care & Specialty Pharmacy
Jonathan R LinderBrian C Lund

Abstract

HealthImpact is a novel algorithm using administrative health care data to stratify patients according to risk for incident diabetes. To (a) independently assess the predictive validity of HealthImpact and (b) explore its utility in diabetes screening within a nationally integrated health care system. National Veterans Health Administration data were used to create 2 cohorts. The replication cohort included patients without diagnosed diabetes as of October 1, 2012, to determine if HealthImpact scores were significantly associated with diabetes (type 1 or 2) incidence within the subsequent 3 years. The utility cohort included patients without diagnosed diabetes as of August 1, 2015, and assessed diabetes screening rates in the 2 years surrounding this index date, stratified by HealthImpact scores. The 3-year incidence of diabetes in the replication cohort (n = 3,287,240) was 9.1%. Of 100,617 (3.1%) patients with HealthImpact scores > 90, 30,028 developed diabetes, yielding a positive predictive value of 29.8%. These patients accounted for 9.9% of all incident diabetes cases (sensitivity). Sensitivity and negative predictive value improved with descending HealthImpact threshold scores (e.g., > 75, > 50), whereas specificity and p...Continue Reading

References

May 3, 2001·The New England Journal of Medicine·J TuomilehtoUNKNOWN Finnish Diabetes Prevention Study Group
Nov 30, 2011·BMJ : British Medical Journal·Douglas NobleTrisha Greenhalgh
Sep 23, 2014·American Journal of Preventive Medicine·Sarah Stark CasagrandeSaul M Genuth
Feb 24, 2016·Health Services Research·Rozalina G McCoyChristopher A Hane
Dec 10, 2017·Diabetes Care·UNKNOWN American Diabetes Association

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