Table 1.
Quantitative approach (PROFILe project) | Mixed-method approach (Tailored Healthcare project) | |
---|---|---|
Objective | To develop, validate and test patient profiles as an instrument to support more tailored type 2 diabetes management in primary care | To define and validate patient profiles and to test the effect of integrating profiles in healthcare services, materials and systems on total joint replacement patients’ satisfaction with care provision |
Patient profile development | ||
Target population | Adult patients with type 2 diabetes treated in primary care | Older adults undergoing lower limb joint replacement surgery |
Identification of subgroups | Growth mixture modelling | K-means clustering |
Population size |
~ 10,000 (development cohort) ~ 3000 (validation cohort |
~ 200 (retrospective cohort) ~ 30 (qualitative interviews) |
Prediction of subgroups | Machine learning | Recursive partitioning |
Patient profile use in practice | ||
Assessment: which patient characteristics are assessed? | Body mass index | Coping style |
Glycated haemoglobin | Anxiety | |
Triglycerides | Communication preferences | |
Stratification: how are patients stratified into subgroups? | Healthcare provider enters patients BMI, HbA1c and triglycerides levels into a tool, which enables him/her to view the related subgroup with a similar glycaemic control trajectory | Healthcare provider enters the patient’s scores as determined during the consultation in a decision tree. Alternatively, patients fill out a self-reported questionnaire which is scored according to the decision tree decision rules. A suggestion for the patient’s subgroup is provided along with the level of certainty |
Tailoring: how is care tailored? | Daily diabetes care planning, lifestyle information, help taking medication, frequency of consultations and emotional support are tailored according to the preferences per subgroup | Preoperative education materials and supportive systems for postoperative (tele)rehabilitation are tailored to the preferences per subgroup |