Around the world, the treatment for 3 common chronic diseases is proceeding toward more consistent use over time, especially in the first-line treatment of type 2 diabetes mellitus, according to a study published online in Proceedings of the National Academy of Sciences (PNAS).
Hypertension and depression have substantially less agreement, as does the second-line treatment of diabetes, according to the international observational study led by Columbia University researchers, performed in collaboration with the Observational Health Data Sciences and Informatics (OHDSI) program.
"We see substantial variation in treatment across nations and across practice types," said lead author George Hripcsak, MD, MS, Vivian Beaumont Allen Professor and chair of Biomedical Informatics at Columbia University Medical Center (CUMC), principal investigator of the OHDSI coordinating center and director of Medical Informatics Services at New York-Presbyterian/CUMC.
Using data from 250 million patient records in 4 countries, the study demonstrates the feasibility of performing large-scale observational research to obtain information about clinical practice among diverse groups of patients.
The researchers used the Observational Health Data Sciences and Informatics, or OHDSI (pronounced "odyssey") program to combine and analyze patient data from widely different sources in the United States and abroad. This enabled the researchers to collect data from 250 million patient records in 4 countries to assess patterns and variations in treatment of patients with the 3 common chronic diseases.
"Each participating site converted their data to the OHDSI data model and used the OHDSI tools set to run the identical query around the world," Hripcsak said. "A record qualified for the study if the patient had 1 of the 3 chronic diseases, had been observed without treatment for at least a year, and had been observed on treatment continually for at least 3 years."