Performance assessment across different care settings of a heart failure hospitalisation risk-score for type 2 diabetes using administrative claims
Abstract Predicting the risk of cardiovascular complications, in particular heart failure hospitalisation (HHF), can improve the management of type 2 diabetes (T2D). Most predictive models proposed so far rely on clinical data not available at the higher Institutional level. Therefore, it is of inte...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-05-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-11758-9 |
| _version_ | 1811253231251095552 |
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| author | Alessandro Guazzo Enrico Longato Mario Luca Morieri Giovanni Sparacino Bruno Franco-Novelletto Maurizio Cancian Massimo Fusello Lara Tramontan Alessandro Battaggia Angelo Avogaro Gian Paolo Fadini Barbara Di Camillo |
| author_facet | Alessandro Guazzo Enrico Longato Mario Luca Morieri Giovanni Sparacino Bruno Franco-Novelletto Maurizio Cancian Massimo Fusello Lara Tramontan Alessandro Battaggia Angelo Avogaro Gian Paolo Fadini Barbara Di Camillo |
| author_sort | Alessandro Guazzo |
| collection | DOAJ |
| description | Abstract Predicting the risk of cardiovascular complications, in particular heart failure hospitalisation (HHF), can improve the management of type 2 diabetes (T2D). Most predictive models proposed so far rely on clinical data not available at the higher Institutional level. Therefore, it is of interest to assess the risk of HHF in people with T2D using administrative claims data only, which are more easily obtainable and could allow public health systems to identify high-risk individuals. In this paper, the administrative claims of > 175,000 patients with T2D were used to develop a new risk score for HHF based on Cox regression. Internal validation on the administrative data cohort yielded satisfactory results in terms of discrimination (max AUROC = 0.792, C-index = 0.786) and calibration (Hosmer–Lemeshow test p value < 0.05). The risk score was then tested on data gathered from two independent centers (one diabetes outpatient clinic and one primary care network) to demonstrate its applicability to different care settings in the medium-long term. Thanks to the large size and broad demographics of the administrative dataset used for training, the proposed model was able to predict HHF without significant performance loss concerning bespoke models developed within each setting using more informative, but harder-to-acquire clinical variables. |
| first_indexed | 2024-04-12T16:46:47Z |
| format | Article |
| id | doaj.art-1c8a53bef208449a9bb23ea74d0375c8 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-12T16:46:47Z |
| publishDate | 2022-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-1c8a53bef208449a9bb23ea74d0375c82022-12-22T03:24:32ZengNature PortfolioScientific Reports2045-23222022-05-0112111110.1038/s41598-022-11758-9Performance assessment across different care settings of a heart failure hospitalisation risk-score for type 2 diabetes using administrative claimsAlessandro Guazzo0Enrico Longato1Mario Luca Morieri2Giovanni Sparacino3Bruno Franco-Novelletto4Maurizio Cancian5Massimo Fusello6Lara Tramontan7Alessandro Battaggia8Angelo Avogaro9Gian Paolo Fadini10Barbara Di Camillo11Department of Information Engineering, University of PadovaDepartment of Information Engineering, University of PadovaDepartment of Medicine, University of PadovaDepartment of Information Engineering, University of PadovaScuola Veneta di Medicina Generale (SVEMG)Scuola Veneta di Medicina Generale (SVEMG)Scuola Veneta di Medicina Generale (SVEMG)Arsenàl.IT, Veneto’s Research Centre for eHealth InnovationScuola Veneta di Medicina Generale (SVEMG)Department of Medicine, University of PadovaDepartment of Medicine, University of PadovaDepartment of Information Engineering, University of PadovaAbstract Predicting the risk of cardiovascular complications, in particular heart failure hospitalisation (HHF), can improve the management of type 2 diabetes (T2D). Most predictive models proposed so far rely on clinical data not available at the higher Institutional level. Therefore, it is of interest to assess the risk of HHF in people with T2D using administrative claims data only, which are more easily obtainable and could allow public health systems to identify high-risk individuals. In this paper, the administrative claims of > 175,000 patients with T2D were used to develop a new risk score for HHF based on Cox regression. Internal validation on the administrative data cohort yielded satisfactory results in terms of discrimination (max AUROC = 0.792, C-index = 0.786) and calibration (Hosmer–Lemeshow test p value < 0.05). The risk score was then tested on data gathered from two independent centers (one diabetes outpatient clinic and one primary care network) to demonstrate its applicability to different care settings in the medium-long term. Thanks to the large size and broad demographics of the administrative dataset used for training, the proposed model was able to predict HHF without significant performance loss concerning bespoke models developed within each setting using more informative, but harder-to-acquire clinical variables.https://doi.org/10.1038/s41598-022-11758-9 |
| spellingShingle | Alessandro Guazzo Enrico Longato Mario Luca Morieri Giovanni Sparacino Bruno Franco-Novelletto Maurizio Cancian Massimo Fusello Lara Tramontan Alessandro Battaggia Angelo Avogaro Gian Paolo Fadini Barbara Di Camillo Performance assessment across different care settings of a heart failure hospitalisation risk-score for type 2 diabetes using administrative claims Scientific Reports |
| title | Performance assessment across different care settings of a heart failure hospitalisation risk-score for type 2 diabetes using administrative claims |
| title_full | Performance assessment across different care settings of a heart failure hospitalisation risk-score for type 2 diabetes using administrative claims |
| title_fullStr | Performance assessment across different care settings of a heart failure hospitalisation risk-score for type 2 diabetes using administrative claims |
| title_full_unstemmed | Performance assessment across different care settings of a heart failure hospitalisation risk-score for type 2 diabetes using administrative claims |
| title_short | Performance assessment across different care settings of a heart failure hospitalisation risk-score for type 2 diabetes using administrative claims |
| title_sort | performance assessment across different care settings of a heart failure hospitalisation risk score for type 2 diabetes using administrative claims |
| url | https://doi.org/10.1038/s41598-022-11758-9 |
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