ArticleMedical decision making : an international journal of the Society for Medical Decision Making2019
Development and Validation of the Real-World Progression in Diabetes (RAPIDS) Model.
Article in Medical decision making : an international journal of the Society for Medical Decision Making, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- PERsonalised Medicine for Intensification of Treatment (PERMIT) in type 2 diabetes mellitus: a target trial emulation from routine data.Health technology assessment (Winchester, England) · 2026Article
- Development and Internal Validation of the Multiethnic Type 2 Diabetes Outcomes Model for the U.S. (DOMUS).Diabetes care · 2025Article
- Long-term outcomes following alternative second-line oral glucose-lowering treatments: Results from the real-world progression in type 2 diabetes mellitus United Kingdom (RAPIDS-UK) model.Diabetes, obesity & metabolism · 2025Article
- Development and validation of a type 2 diabetes model to estimate the cost-effectiveness of diabetes interventions across the care continuum.International journal of technology assessment in health care · 2025Article
- Updating and calibrating the Real-World Progression In Diabetes (RAPIDS) model in a non-Veterans Affairs population.Diabetes, obesity & metabolism · 2024Article
- Using Joint Longitudinal and Time-to-Event Models to Improve the Parameterization of Chronic Disease Microsimulation Models: an Application to Cardiovascular Disease.medRxiv : the preprint server for health sciences · 2024Article
- Article
- The sequence of disease-modifying anti-rheumatic drugs: pathways to and predictors of tocilizumab monotherapy.Arthritis research & therapy · 2021Article
- A Patient-Level Model to Estimate Lifetime Health Outcomes of Patients With Type 1 Diabetes.Diabetes care · 2020Article
- Development and Validation of the US Diabetes, Obesity, Cardiovascular Disease Microsimulation (DOC-M) Model: Health Disparity and Economic Impact Model.Medical decision making : an international journal of the Society for Medical Decision MakingArticle
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Authors and funding
6 authors.
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Abstract
introductionTo develop and validate the first real-world data-based type 2 diabetes progression model (RAPIDS) employing econometric techniques that can study the comparative effects of complex dynamic patterns of glucose-lowering drug use.
methodsThe US Department of Veterans Affairs (VA) electronic medical record and claims databases were used to identify over 500,000 diabetes patients in 2003 with up to 9-year follow-up. The RAPIDS model contains interdependent first-order Markov processes over quarters for each of the micro- and macrovascular events, hypoglycemia, and death, as well as predictive models for 8 biomarker levels. Model parameters varied by static demographic factors and dynamic factors, such as age, duration of diabetes, 13 possible glucose-lowering treatment combinations, any blood pressure and any cholesterol-lowering medications, and cardiovascular history. To illustrate model capabilities, a simple comparative study was set up to compare observed treatment use patterns to alternate patterns if perfect adherence is assumed following initiating the use of any of these medications.
resultsData were randomly split into 307,288, 105,195, and 105,081 patients to perform estimation, out-of-sample calibration, and validation, respectively. Model predictions in the validation sample closely aligned with the observed longitudinal trajectory of biomarkers and outcomes. Perfect adherence among initiators increased proportion of days covered by only 6 months. Most of this increase came from increased adherence to monotherapies and did not lead to meaningful changes in any of the outcomes over the 9-year period.
conclusionFuture value of increasing medication adherence among VA patients with diabetes may lie among those who never initiate treatment or are late in initiating treatment. The first-of-its-kind real-world data-based model has the potential to carry out many complex comparative-effectiveness research (CER) studies of dynamic glucose-lowering drug regimens.
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