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Exploring Variation...
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Charalampopoulos, DimitriosUCL, England
(författare)
Exploring Variation in Glycemic Control Across and Within Eight High-Income Countries: A Cross-sectional Analysis of 64,666 Children and Adolescents With Type 1 Diabetes
- Artikel/kapitelEngelska2018
Förlag, utgivningsår, omfång ...
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2018-04-12
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AMER DIABETES ASSOC,2018
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:liu-148378
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-148378URI
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https://doi.org/10.2337/dc17-2271DOI
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https://gup.ub.gu.se/publication/268836URI
Kompletterande språkuppgifter
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Språk:engelska
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Sammanfattning på:engelska
Ingår i deldatabas
Klassifikation
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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Funding Agencies|England Department of Health Policy Research Programme [10090001]; National Institute for Health Research Biomedical Research Centre at Great Ormond Street Hospital for Children National Health Service Foundation Trust; University College London; National Health Service England; Welsh Government; South Eastern Norway Regional Health Authority; Health Research Fund of Central Denmark Region; Swedish Association of Local Authorities and Regions (SALAR); German Center for Diabetes Research (DZD); German Diabetes Association (DDG); European Foundation for the Study of Diabetes (EFSD); EU-IMI2 consortium INNODIA; Helmsley Charitable Trust; National Institute of Diabetes and Digestive and Kidney Diseases; Eunice Kennedy Shriver National Institute of Child Health and Human Development; Jaeb Center for Health Research
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OBJECTIVE International studies on childhood type 1 diabetes (T1D) have focused on whole-country mean HbA(1c) levels, thereby concealing potential variations within countries. We aimed to explore the variations in HbA(1c) across and within eight high-income countries to best inform international benchmarking and policy recommendations. RESEARCH DESIGN AND METHODS Data were collected between 2013 and 2014 from 64,666 children with T1D who were amp;lt; 18 years of age across 528 centers in Germany, Austria, England, Wales, U.S., Sweden, Denmark, and Norway. We used fixed-and random-effects models adjusted for age, sex, diabetes duration, and minority status to describe differences between center means and to calculate the proportion of total variation in HbA(1c) levels that is attributable to between-center differences (intraclass correlation [ICC]). We also explored the association between within-center variation and childrens glycemic control. RESULTS Sweden had the lowest mean HbA(1c) (59mmol/mol [7.6%]) and together with Norway and Denmark showed the lowest between-center variations (ICC amp;lt;= 4%). Germany and Austria had the next lowest mean HbA(1c) (61-62 mmol/mol [7.7-7.8%]) but showed the largest center variations (ICC similar to 15%). Centers in England, Wales, and the U.S. showed low-to-moderate variation around high mean values. In pooled analysis, differences between counties remained significant after adjustment for children characteristics and center effects (P value amp;lt; 0.001). Across all countries, children attending centers with more variable glycemic results had higher HbA(1c) levels (5.6mmol/mol [0.5%] per 5mmol/mol [0.5%] increase in center SD of HbA(1c) values of all children attending a specific center). CONCLUSIONS A tsimilar average levels of HbA(1c), countries display different levels of center variation. The distribution of glycemic achievement within countries should be considered in developing informed policies that drive quality improvement.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Hermann, Julia M.Ulm Univ, Germany; German Ctr Diabet Res DZD, Germany
(författare)
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Svensson, JannetHerlev Univ Hosp, Denmark
(författare)
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Skrivarhaug, TorildOslo Univ Hosp, Norway
(författare)
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Maahs, David M.Stanford Univ, CA 94305 USA
(författare)
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Åkesson, KarinLinköpings universitet,Avdelningen för barns och kvinnors hälsa,Medicinska fakulteten(Swepub:liu)karak14
(författare)
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Warner, Justin T.Childrens Hosp Wales, Wales
(författare)
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Holl, Reinhard W.Ulm Univ, Germany; German Ctr Diabet Res DZD, Germany
(författare)
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Birkebaek, Niels H.Aarhus Univ Hosp, Denmark
(författare)
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Drivvoll, Ann K.Oslo Univ Hosp, Norway
(författare)
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Miller, Kellee M.Jaeb Ctr Hlth Res, FL USA
(författare)
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Svensson, Ann-MarieCtr Registers Reg Vastra Gotaland, Sweden
(författare)
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Stephenson, TerenceUniversity College London, London, U.K.
(författare)
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Hofer, Sabine E.Med Univ Innsbruck, Austria
(författare)
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Fredheim, SiriHerlev University Hospital, Herlev, Denmark
(författare)
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Kummernes, Siv J.Oslo Univ Hosp, Norway
(författare)
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Foster, NicoleJaeb Ctr Hlth Res, FL USA
(författare)
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Hanberger, Lena,1957-Linköpings universitet,Avdelningen för omvårdnad,Medicinska fakulteten,Region Östergötland, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus(Swepub:liu)lenha57
(författare)
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Amin, RakeshUCL, England
(författare)
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Rami-Merhar, BirgitMed Univ Vienna, Austria
(författare)
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Johansen, AndersUniv Copenhagen, Denmark
(författare)
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Dahl-Jorgensen, KnutOslo Univ Hosp, Norway; Univ Oslo, Norway
(författare)
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Clements, MarkChildrens Mercy Hosp, MO 64108 USA; Univ Missouri Kansas City, MO USA; Univ Kansas, KS 66103 USA
(författare)
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Hanås, Ragnar,1951Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics(Swepub:gu)xhanra
(författare)
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UCL, EnglandUlm Univ, Germany; German Ctr Diabet Res DZD, Germany
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Diabetes Care: AMER DIABETES ASSOC41:6, s. 1180-11870149-59921935-5548
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Charalampopoulos ...
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Hermann, Julia M ...
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Svensson, Jannet
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Skrivarhaug, Tor ...
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Maahs, David M.
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Åkesson, Karin
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visa fler...
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Warner, Justin T ...
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Holl, Reinhard W ...
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Birkebaek, Niels ...
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Drivvoll, Ann K.
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Miller, Kellee M ...
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Svensson, Ann-Ma ...
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Stephenson, Tere ...
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Hofer, Sabine E.
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Fredheim, Siri
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Kummernes, Siv J ...
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Foster, Nicole
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Hanberger, Lena, ...
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Amin, Rakesh
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Rami-Merhar, Bir ...
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Johansen, Anders
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Dahl-Jorgensen, ...
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Clements, Mark
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Hanås, Ragnar, 1 ...
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Diabetes Care
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Linköpings universitet
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