Table 2.
Studies of decision support tools for type 2 diabetes mellitus which provide support for standard diabetes care without personalization
| Primary author, study year |
Target audience |
Study characteristics | Goal | Decisions and outcomes affected |
|---|---|---|---|---|
| Cleveringa, et al. 2008 | Physician, nurse | 3,391 Patients, cluster-randomized trial. | Improve clinical markers (A1c, BP, cholesterol). | Targeted at overall management. Decreased total cholesterol, LDL, BP. No significant change in HbA1c. |
| Holbrook, et al. 2009 | Physicians, patients | 46 Clinicians, 511 Patients, cluster-randomized trial, 1 year enrollment period. | Improve frequency and ease of assessing diabetes markers. | Targeted at overall management and frequency of certain assessments. Improved quality of monitoring. Resulted in lower BP and HbA1c. |
| Hunt, et al. 2009 | Physician | 4,265 continuously enrolled patients. Pre-post intervention, two year study period. | Improve clinical markers (HbA1c, BP, cholesterol), and process of care. | Targeted at overall management. Decreased LDL, BP. Improved LDL and HbA1c testing. Did not reduce mean HbA1c, but did improve percent of patients at HbA1c goal. |
| MacLean, et al. 2009 | Physicians, patients | 7,412 patients, cluster-randomized trial, 32 month study period. | Evaluate the effect of support system on processes of care and outcomes. | Targeted at overall management. Improved likelihood of testing for cholesterol, creatinine, and proteinuria, but not HbA1C. Did not impact HbA1c or LDL levels. |
| Augstein, et al. 2010 | Physician | 359 Patients, retrospective, observational study. | Improve glycemic control. | Targeted at overall management, emphasis on glycemic control. Decreased HbA1c, mean sensor glucose, and glucose variability. |
| O'Connor, et al. 2011 | Physician | 41 Clinicians, 2,556 Patients, cluster-randomized trial, 9 month study period. | Reduce HbA1C, BP, LDL | Targeted at overall management. Improved HbA1c and SBP, not LDL. |
| Quinn, et al. 2011 | Physicians, patients | 163 Patients, cluster-randomized trial, 1-year treatment period. | Reduce HbA1c. | Targeted at overall management. Certain forms of the intervention reduced HbA1c over 1 year compared with usual care. |
| Saenz, et al. 2012 | Physician | 66 Clinicians and 697 Patients, Cluster-randomized trial, 18-month study period. | Reduce HbA1c | How to use insulin in type II diabetes. Reduced HbA1c. |
| Leal, et al. 2009 | Not specified. | Development of life expectancy tables based on the United Kingdom Prospective Diabetes. | Develop a tool to help predict life expectancy. | Study describes tool. Presumably the decision relates to addressing modifiable risks in an attempt to improve life expectancy. |
| Rodbard, et al. 2011 | Physician, patients | Development of computerized clinical decision support tool for patients with type 2 diabetes. | Improve glycemic control. | Targeted at glycemic management. Currently being tested. |
HbA1c = hemoglobin A1c; BP = blood pressure; SBP = systolic blood pressure; LDL = low-density lipoprotein cholesterol.