Evidence map›Paper›PMID 24923707›Full record

ArticlePharmacoepidemiology and drug safety2014

Misclassification in assessment of diabetogenic risk using electronic health records.

Almut G Winterstein, Paul Kubilis, Steve Bird, Rhonda M Cooper-DeHoff, Greg A Nichols, Joseph A Delaney

Open access · greenAbstract read
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.2field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Almut G WintersteinPharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA; Epidemiology, Colleges of Public Health and Health Professions and Medicine, University of Florida, Gainesville, FL, USA.
Paul Kubilis
Steve Bird
Rhonda M Cooper-DeHoff
Greg A Nichols
Joseph A Delaney
University of Florida · USCenter for Drug Evaluation and Research · USKaiser Permanente Center for Health Research · USUniversity of Washington · US

Funding

Pharmacogenomic Evaluation of Antihypertensive ResponsesU01GM074492 · NIGMS · UNIVERSITY OF FLORIDA · PI COOPER-DEHOFF, RHONDA M, JOHNSON, JULIE A. · 2005 to 2014
$20.7M
NIGMS NIH HHS U01 GM074492
6 · The paper itself

Abstract

purposeSuspected diabetogenic effects or drug indication may increase testing for diabetes mellitus (DM), resulting in measurement bias when evaluating diabetogenic drug effects. We sought to evaluate the validity of electronic health record data in determining DM risk.

methodsWe used time-dependent Cox proportional hazard models within a retrospective cohort design to assess associations between use of antihypertensives, statins, atypical antipsychotics, and antidepressants, and two endpoints: (i) DM onset defined as fasting blood glucose (BG) ≥126 mg/dl, random BG ≥200 mg/dl, HbA1c ≥7.0%, or antidiabetic drug initiation; and (ii) first negative DM test. We used Poisson regression to assess the influence of these drugs on DM testing rates. Patients aged 35-64 years enrolled in Kaiser Permanente Northwest between 1997 and 2010 entered the cohort at the first negative BG test after ≥6 months without manifest DM.

resultsAll drug classes showed significant associations not only with DM onset but also with first negative BG test and with DM testing rates. Antipsychotics had the greatest diabetogenic risk (adjusted hazard ratio [HR] = 1.73 [1.44-2.08]), the greatest propensity for a first negative test (adjusted HR = 1.87 [1.74-2.01]), and the highest testing rate (adjusted rate ratio = 1.76 [1.72-1.81]. Although renin-angiotensin system blockers and calcium channel blockers have shown no diabetogenic risk in clinical trials, both were associated with DM (HR = 1.19 [1.12-1.26] and 1.27 [1.17-1.38]), a negative glucose test (1.38 [1.35-1.41] and 1.24 [1.20-1.28]), and increased testing rates (rate ratio = 1.26 [1.24-1.27] and 1.27 [1.25-1.28]).

conclusionCaution should be used when diabetogenic risk is evaluated using data that rely on DM testing in general practice.

Indexed as

Epidemiologic Research DesignAdultBiasBlood GlucoseCohort StudiesDiabetes MellitusDrug-Related Side Effects and Adverse ReactionsElectronic Health RecordsEndpoint DeterminationFemaleHumansMaleMiddle AgedPoisson DistributionProportional Hazards ModelsRetrospective StudiesBlood Glucoseantihypertensivesantipsychoticsdiabetogenic riskdrug safetyelectronic health recordsmeasurement biaspharmacoepidemiologystatins

Identifiers

PMID24923707
PMCPMC5012172
OpenAlexW1509115537

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.