The Joint Asia Diabetes Evaluation (JADE) Program: a web-based program to translate evidence to clinical practice in Type 2 diabetes.
OBJECTIVE
The Joint Asia Diabetes Evaluation (JADE) Program is the first web-based program incorporating a comprehensive risk engine, care protocols, clinical decision and self-management support to improve ambulatory diabetes care. The aim was to validate the risk stratification system of the JADE Program using a large prospective cohort.


METHODS
The JADE interactive risk engine stratifies patients into different risk levels using results from an annual comprehensive assessment of complications and risk factors. We used a prospective registry consisting of 7534 Type 2 diabetic patients [45.6% men, median (range) age 57 years (13-92)] to perform internal validation of the risk engine.


RESULTS
The JADE Risk Engine categorized patients into four risk levels (from low to high): level 1, n = 4520 (6%); level 2, n = 1468 (19.5%); level 3, n = 4476 (59.4%); and level 4, n = 1138 (15.1%). After a median follow-up period of 5.5 years (mean +/- sd 5.4 +/- 2.81 years), 763 (10.1%) died, 1129 (14.9%) developed cardiovascular disease (CVD), 282 (3.7%) developed end-stage renal disease and 1400 (18.6%) had at least one of these events. Compared with risk level 1, levels 2, 3 and 4 were associated with 2.8-, 4.7- and 8.6-fold increased risk of clinical end-points. Risk levels 3 and 4 were, respectively, associated with 2.2- and 3.9-fold increased risk for all-cause death and 4.8- and 12.1-fold increased CVD risks.


CONCLUSIONS
Based on results from a comprehensive assessment, the JADE Risk Engine successfully categorizes patients into different risk levels to guide clinical management.
Chan
J
J
Department of Medicine and Therapeutics, Chinese University of Hong Kong, Shatin, Hong Kong. jchan@cuhk.edu.hk
So
W
W
Ko
G
G
Tong
P
P
Yang
X
X
Ma
R
R
Kong
A
A
Wong
R
R
Le Coguiec
F
F
Tamesis
B
B
Wolthers
T
T
Lyubomirsky
G
G
Chow
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia; D015331:Cohort Studies; D020000:Decision Support Systems, Clinical; D003695:Delivery of Health Care / Q000592:standards*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D012042:Registries / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012984:Software; D055815:Young Adult