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Application of standardised effect sizes to hospital discharge outcomes for people with diabetes
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Robbins, Tim, Lim Choi Keung, Sarah Niukyun, Sankaranarayanan, Sailesh, Randeva, Harpal S. and Arvanitis, Theodoros N. (2020) Application of standardised effect sizes to hospital discharge outcomes for people with diabetes. BMC Medical Informatics and Decision Making, 20 . 150. doi:10.1186/s12911-020-01169-z ISSN 1472-6947.
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Official URL: https://doi.org/10.1186/s12911-020-01169-z
Abstract
Background:
Patients with diabetes are at an increased risk of readmission and mortality when discharged from hospital. Existing research identifies statistically significant risk factors that are thought to underpin these outcomes. Increasingly, these risk factors are being used to create risk prediction models, and target risk modifying interventions. These risk factors are typically reported in the literature accompanied by unstandardized effect sizes, which makes comparisons difficult. We demonstrate an assessment of variation between standardised effect sizes for such risk factors across care outcomes and patient cohorts. Such an approach will support development of more rigorous risk stratification tools and better targeting of intervention measures.
Methods:
Data was extracted from the electronic health record of a major tertiary referral centre, over a 3-year period, for all patients discharged from hospital with a concurrent diagnosis of diabetes mellitus. Risk factors selected for extraction were pre-specified according to a systematic review of the research literature. Standardised effect sizes were calculated for all statistically significant risk factors, and compared across patient cohorts and both readmission & mortality outcome measures.
Results:
Data was extracted for 46,357 distinct admissions patients, creating a large dataset of approximately 10,281,400 data points. The calculation of standardized effect size measures allowed direct comparison. Effect sizes were noted to be larger for mortality compared to readmission, as well as for being larger for surgical and type 1 diabetes cohorts of patients.
Conclusions:
The calculation of standardised effect sizes is an important step in evaluating risk factors for healthcare events. This will improve our understanding of risk and support the development of more effective risk stratification tools to support patients to make better informed decisions at discharge from hospital.
Item Type: | Journal Article | |||||||||||||||||||||||||||||||||
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Subjects: | Q Science > QA Mathematics > QA76 Electronic computers. Computer science. Computer software R Medicine > R Medicine (General) R Medicine > RC Internal medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School Faculty of Science, Engineering and Medicine > Engineering > WMG (Formerly the Warwick Manufacturing Group) |
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Library of Congress Subject Headings (LCSH): | Diabetes , Diabetics -- Hospital care, Diabetes -- Patients -- Hospital care, Hospitals -- Admission and discharge -- Data processing | |||||||||||||||||||||||||||||||||
Journal or Publication Title: | BMC Medical Informatics and Decision Making | |||||||||||||||||||||||||||||||||
Publisher: | BioMed Central Ltd. | |||||||||||||||||||||||||||||||||
ISSN: | 1472-6947 | |||||||||||||||||||||||||||||||||
Official Date: | 7 July 2020 | |||||||||||||||||||||||||||||||||
Dates: |
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Volume: | 20 | |||||||||||||||||||||||||||||||||
Article Number: | 150 | |||||||||||||||||||||||||||||||||
DOI: | 10.1186/s12911-020-01169-z | |||||||||||||||||||||||||||||||||
Status: | Peer Reviewed | |||||||||||||||||||||||||||||||||
Publication Status: | Published | |||||||||||||||||||||||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | |||||||||||||||||||||||||||||||||
Date of first compliant deposit: | 17 September 2020 | |||||||||||||||||||||||||||||||||
Date of first compliant Open Access: | 18 September 2020 | |||||||||||||||||||||||||||||||||
Funder: | HDR UK | |||||||||||||||||||||||||||||||||
Grant number: | , and | |||||||||||||||||||||||||||||||||
RIOXX Funder/Project Grant: |
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