Development and Validation of HealthImpact: An Incident Diabetes Prediction Model Based on Administrative Data

Rozalina G. McCoy, Vijay S. Nori, Steven A. Smith, Christopher A. Hane

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objective: To develop and validate a model of incident type 2 diabetes based solely on administrative data. Data Sources/Study Setting: Optum Labs Data Warehouse (OLDW), a national commercial administrative dataset. Study Design: HealthImpact model was developed and internally validated using nested case–control study design; n = 473,049 in training cohort and n = 303,025 in internal validation cohort. HealthImpact was externally validated in 2,000,000 adults followed prospectively for 3 years. Only adults ≥18 years were included. Data Collection/Extraction Methods: Patients with incident diabetes were identified using HEDIS rules. Control subjects were sampled from patients without diabetes. Medical and pharmacy claims data collected over 3 years prior to index date were used to build the model variables. Principal Findings: HealthImpact, scored 0–100, has 48 variables with c-statistic 0.80815. We identified HealthImpact threshold of 90 as identifying patients at high risk of incident diabetes. HealthImpact had excellent discrimination in external validation cohort (c-statistic 0.8171). The sensitivity, specificity, positive predictive value, and negative predictive value of HealthImpact >90 for new diagnosis of diabetes within 3 years were 32.35, 94.92, 22.25, and 96.90 percent, respectively. Conclusions: HealthImpact is an efficient and effective method of risk stratification for incident diabetes that is not predicated on patient-provided information or laboratory tests.

Original languageEnglish (US)
Pages (from-to)1896-1918
Number of pages23
JournalHealth Services Research
Volume51
Issue number5
DOIs
StatePublished - Oct 1 2016

Keywords

  • Diabetes mellitus type 2
  • decision support techniques
  • risk assessment/methods
  • theoretical models

ASJC Scopus subject areas

  • Health Policy

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