Construction of a multisite DataLink using electronic health records for the identification, surveillance, prevention, and management of diabetes mellitus: the SUPREME-DM project.
BACKGROUND
Electronic health record (EHR) data enhance opportunities for conducting surveillance of diabetes. The objective of this study was to identify the number of people with diabetes from a diabetes DataLink developed as part of the SUPREME-DM (SUrveillance, PREvention, and ManagEment of Diabetes Mellitus) project, a consortium of 11 integrated health systems that use comprehensive EHR data for research.


METHODS
We identified all members of 11 health care systems who had any enrollment from January 2005 through December 2009. For these members, we searched inpatient and outpatient diagnosis codes, laboratory test results, and pharmaceutical dispensings from January 2000 through December 2009 to create indicator variables that could potentially identify a person with diabetes. Using this information, we estimated the number of people with diabetes and among them, the number of incident cases, defined as indication of diabetes after at least 2 years of continuous health system enrollment.


RESULTS
The 11 health systems contributed 15,765,529 unique members, of whom 1,085,947 (6.9%) met 1 or more study criteria for diabetes. The nonstandardized proportion meeting study criteria for diabetes ranged from 4.2% to 12.4% across sites. Most members with diabetes (88%) met multiple criteria. Of the members with diabetes, 428,349 (39.4%) were incident cases.


CONCLUSIONS
The SUPREME-DM DataLink is a unique resource that provides an opportunity to conduct comparative effectiveness research, epidemiologic surveillance including longitudinal analyses, and population-based care management studies of people with diabetes. It also provides a useful data source for pragmatic clinical trials of prevention or treatment interventions.
Kaiser Permanente Center for Health Research, 3800 N Interstate Ave, Portland, OR 97227, USA. Greg.nichols@kpchr.org
Gregory A
GA
Nichols
Jay
J
Desai
Jennifer
J
Elston Lafata
Jean M
JM
Lawrence
Patrick J
PJ
O'Connor
Ram D
RD
Pathak
Marsha A
MA
Raebel
Robert J
RJ
Reid
Joseph V
JV
Selby
Barbara G
BG
Silverman
John F
JF
Steiner
W F
WF
Stewart
Suma
S
Vupputuri
Beth
B
Waitzfelder
D017668:Age of Onset; D002648:Child; D003625:Data Collection / Q000379:methods*; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D019468:Disease Management; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D008329:Managed Care Programs; D008498:Medical Record Linkage; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D012042:Registries; D014481:United States / Q000453:epidemiology; D014584:User-Computer Interface