The proposed EHR-based approach will quantify the T2DM severity for primary care performance management and inform the methodology for measuring severity of other primary care-managed chronic conditions .
INTRODUCTION The increasing prevalence of type 2 diabetes mellitus ( T2DM ) presents a significant burden on affected individuals and healthcare systems internationally .
There is , however , no agreed vali date d measure to infer diabetes severity from electronic health records ( EHRs ) .
We aim to quantify T2DM severity and vali date it using clinical adverse outcomes .
The Impact of Patient-Centered versus Didactic Education Programs in Chronic Patients by Severity: The Case of Type 2 Diabetes Mellitus.
BACKGROUND Education leads to better health-related decisions and protective behaviors , being especially important for patients with chronic conditions .  Self-management education programs have been shown to be beneficial for patients with different chronic conditions and to have a higher impact on health outcomes than does didactic education . OBJECTIVE To investigate improvements in glycemic control ( measured by glycated hemoglobin A1c ) in patients with type 2 diabetes mellitus . METHODS Our comparative trial involved one group of patients receiving patient-centered education and another receiving didactic education .  We dealt with selection bias issues , estimated the different impact of both programs , and vali date d our analysis using quantile regression techniques . RESULTS We found evidence of better mean glycemic control in patients receiving the patient-centered program , which engaged better patients . Nevertheless , that differential impact is nonmonotonic . Patients initially at the healthy range at the patient-centered program maintained their condition better . Patients close to , but not within , the healthy range benefited equally from attending either program . Patients with very high  glycemic level benefited significantly more from attending the patient-centered program . Finally , patients with the worst initial glycemic control ( far from the healthy range ) improved equally their diabetic condition , regardless of which program they attended . CONCLUSIONS Different patients are sensitive to different categories of education programs . The optimal , cost-effective design of preventative programs for patients with chronic conditions needs to account for the different impact in different " patient categories . " This implies stratifying patients and providing the appropriate preventative education program , or looking for alternative policy implementations for unresponsive patients who have the most severe condition and are the most costly
The proposed EHR-based approach will quantify the T2DM severity for primary care performance management and inform the methodology for measuring severity of other primary care-managed chronic conditions .
INTRODUCTION The increasing prevalence of type 2 diabetes mellitus ( T2DM ) presents a significant burden on affected individuals and healthcare systems internationally .
There is , however , no agreed vali date d measure to infer diabetes severity from electronic health records ( EHRs ) .
We aim to quantify T2DM severity and vali date it using clinical adverse outcomes .