Detecting Secular Trends in Clinical Treatment through Temporal Analysis.

{"article_title":"Detecting Secular Trends in Clinical Treatment through Temporal Analysis.","author":"Redd D, Shao Y, Cheng Y, Zeng-Treitler Q","journal_title":"Journal of medical systems","issn":"1573-689X","isbn":"","publication_date":"2019 Feb 12","volume":"43","issue":"3","first_page":"74","page_count":"","accession_number":"30756197","doi":"10.1007\/s10916-019-1173-0","publisher":"Kluwer Academic\/Plenum Publishers","doctype":"Journal Article","subjects":"United States; International Classification of Diseases trends; Practice Patterns, Physicians' trends; United States Department of Veterans Affairs trends; Blood Glucose; Diabetes Mellitus, Type 2 drug therapy; Diabetes Mellitus, Type 2 epidemiology; Diagnostic Techniques and Procedures statistics & numerical data; Glycated Hemoglobin; Humans; Hypoglycemic Agents therapeutic use; Practice Guidelines as Topic; Prescription Drugs; United States; Vaccination statistics & numerical data","interest_area":["Internal\/Family Medicine"," Endocrinology"],"abstract":"Medical treatments change over time for multiple reasons, including introduction of new treatments, availability of new scientific evidence, change in institutional guidelines, and market efforts by pharmaceutical and medical device companies. Monitoring and analyzing these secular trends will also inform the evaluation of evidence based practice as well as outcome research. Using a large national clinical dataset from the United States Veterans Health Administration (VHA), we measured the change in prevalence of all diseases, medications, and procedures by year from 2001 to 2014. To assess statistical significance, we used a generalized linear model. Among the large number of changes that were observed, multiple significant changes were related to diabetes mellitus type II (DM2). Prevalence of DM2 in the VHA increased after 2001 but plateaued by 2008; blood sugar testing by glycosylated hemoglobin increased consistently while glucose testing decreased; and the trend of insulin and metformin use was consistent with the trend in DM2 prevalence, while glyburide and rosiglitazone use dropped sharply.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=30756197&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Redd D, Shao Y, Cheng Y, Zeng-Treitler Q","Journal_Info":"Publisher: Kluwer Academic\/Plenum Publishers Country of Publication: United States NLM ID: 7806056 Publication Model: Electronic Cited Medium: Internet ISSN: 1573-689X (Electronic) Linking ISSN: 01485598 NLM ISO Abbreviation: J Med Syst Subsets: MEDLINE","Publication_Type":"Journal Article","Published_Date":"2019-02-12","Source":"Journal of medical systems [J Med Syst] 2019 Feb 12; Vol. 43 (3), pp. 74. Date of Electronic Publication: 2019 Feb 12.","Languages":"English","Electronic_ISSN":"1573-689X","MeSH_Terms":"International Classification of Diseases\/*trends , Practice Patterns, Physicians'\/*trends , United States Department of Veterans Affairs\/*trends, Blood Glucose ; Diabetes Mellitus, Type 2\/drug therapy ; Diabetes Mellitus, Type 2\/epidemiology ; Diagnostic Techniques and Procedures\/statistics & numerical data ; Glycated Hemoglobin ; Humans ; Hypoglycemic Agents\/therapeutic use ; Practice Guidelines as Topic ; Prescription Drugs ; United States ; Vaccination\/statistics & numerical data","Subjects":"Blood Glucose, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 epidemiology, Diagnostic Techniques and Procedures statistics & numerical data, Glycated Hemoglobin, Humans, Hypoglycemic Agents therapeutic use, Practice Guidelines as Topic, Prescription Drugs, United States, Vaccination statistics & numerical data, International Classification of Diseases trends, Practice Patterns, Physicians' trends, United States Department of Veterans Affairs trends","Title_Abbreviations":"Journal of medical systems","Volume":"43"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"30756197","RelevancyScore":"822","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"822.27197265625"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=30756197&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=30756197&authtype=shib&custid=ns346513&group=main&profile=eds"}