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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

A simple diabetes vascular severity staging instrument and its application to a Torres Strait Islander and Aboriginal adult cohort of north Australia

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Odette R Gibson, Leonie Segal, Robyn A McDermott
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-185) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

O.G. revised the existing instrument, researched data, contributed to the discussion, analyzed the data and drafted the manuscript. L.S revised the existing instrument, designed the study, contributed to the discussion and reviewed/edited the manuscript. R.M. revised the existing instrument, researched data, contributed to the discussion and critically reviewed the manuscript for important intellectual content. All authors read and approved the final manuscript.

Abstract

Background

To develop an instrument that predicts diabetes-related vascular disease severity using routinely collected data on Australian Aboriginal and Torres Strait Islander adults with type 2 diabetes, in the absence of diabetes duration.

Methods

A complex diabetes severity classification system was simplified and adapted for use with an Australian Aboriginal and Torres Strait Islander adult population with type 2 diabetes in north Queensland. Detailed vascular health risks and morbidities were mapped to routinely collected measures. Individual–level health screening, hospital separation and mortality data were linked and used to plot mean monthly in-patient hospital cost and percent mortality by disease severity as defined by the newly developed instrument, to test construct validity.

Results

The revised instrument consists of four combined diabetes-related microvascular and macrovascular stages that range from least severe (stage 1) to severe irreversible vascular impairment (stage 4). When applied to data of an Aboriginal and Torres Strait Islander Australian population the instrument showed good construct validity, predicting higher hospital cost and mortality as vascular disease severity increased.

Conclusions

This instrument discriminates between levels of diabetes-related vascular disease severity, displays good construct validity by predicting increased hospital cost and mortality with worsening severity and can be populated with routinely collected data. It may assist with future health service research and its use could be extended to practice settings for health care planning for diabetes management programs and monitoring vascular disease progression.
Zusatzmaterial
Authors’ original file for figure 1
12913_2011_2037_MOESM1_ESM.pdf
Authors’ original file for figure 2
12913_2011_2037_MOESM2_ESM.pdf
Authors’ original file for figure 3
12913_2011_2037_MOESM3_ESM.pdf
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