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Learning Effec,ve Clinical Treatment Pathways for Type-‐2 Diabetes
Rohit Vashisht
OHDSI Symposium October 19-‐20, North Bethesda, MD, USA
Guidelines versus Prac,ce of Medicine in T2D
?Jane E. B Reush & Joann Manson JAMA 2017 Hripcsak et al PNAS 2016
Learning Effec,ve Treatment Pathways from Observa,onal Data: Analysis of over 103 million pa3ents in 4 Countries
Cohort Construc,on
Drug Efficacy – Sulfonylurea vs DPP4 Inhibitors S
urvi
val P
roba
bilit
y S
urvi
val =
Red
uctio
n in
HbA
1c <
= 7%
HbA1c (0.77 [0.58, 1.02])
Prob
abili
ty o
f rem
aini
ng M
I fre
e af
ter t
reat
men
t Myocardial Infarction (0.93 [0.55, 1.57])
Prob
abili
ty o
f rem
aini
ng K
D fr
ee a
fter t
reat
men
t
Kidney disorder (1.15 [0.45, 2.80])
Prob
abili
ty o
f rem
aini
ng E
D fr
ee a
fter t
reat
men
t
Eye disorder (1.30 [0.57, 3.05])
Replica,on at Other Sites & Meta-‐Analysis
Conclusion
• DPP4-‐Inhibitors appear to be more effec,ve in reducing HbA1c of T2D pa,ents
– There is no detectable difference in events related to myocardial infarc,on, kidney-‐ and eye-‐related disorders.
• OHDSI plaXorm enables us to perform large-‐scale observa,onal studies and assess their reproducibility.
– If you have your data in OHDSI format then please
par,cipate in this study.
Thank You [email protected]
Team -‐ Stanford • Nigam Shah • Suzanne Tamang • Alison Callahan • Sarah Pool • Juan M Banda • Ken Jung • Vladimir Polony • Vibhu Agarwal • Alejandro Schuler
Team -‐ JnJ • Patrick Ryan • James Weaver • Mar,jn Schuemie
Team – Ajou University, Korea • Rae Woong Park • Young Gun • Sanghyung Jin
Team – Cerner • Hua Xu • Yonghui Wu
Team – Mt. Sinai • Li Li • Joel. T Dudley
Team – Columbia • Peng Jin • Karthik Natrajan • George Hripcsak • Maura Beaton
Team -‐ IMSQuin,les • Mui Van Zandt • Anthony Reckard • Chris,an Reich
