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Full text release has been delayed at the author's request until January 31, 2025

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DEVELOPMENT AND VALIDATION OF CLINICAL PREDICTION TOOLS FOR AIDING IN SELECTION OF 2ND LINE THERAPIES ADDED TO METFORMIN IN TREATMENT OF TYPE 2 DIABETES

El Sanadi, Caroline Elizabeth
http://rave.ohiolink.edu/etdc/view?acc_num=case1607604907339227

Abstract Details

2020, Doctor of Philosophy, Case Western Reserve University, Epidemiology and Biostatistics.
The overall purpose of this project was to determine and develop clinical tools that aid in medical decision-making for clinicians and their patients when they are faced with decisions regarding which 2nd-line therapy to add on to metformin monotherapy. Outcomes-based approaches were used as they provide clinically meaningful touchpoints for clinicians, and helpful discussion points for patients. It was hypothesized that such tools developed using large data sets and rigorous evaluation methods would perform better at predicting likelihood of certain outcomes than chance or random guessing would, and that these tools could prove useful to clinicians in using evidence to aid and streamline the decision process. The first tool was created to evaluate the likelihood of developing the five most common outcomes for persons with type 2 diabetes when a 2nd-line therapy is added to metformin monotherapy. The hypothesis was correct; the tool demonstrated strong discriminative ability and performed well on standard prediction model evaluations. The second project compared the impact of adding a 2nd-line of either GLP-1RA or DPP-4i on developing a 3-Point MACE outcome. It was hypothesized that, given the large size of the study dataset, results predicting 3P-MACE outcome would be comparable to those observed in many of the recent large cardiovascular outcome trials (CVOTs), however, unlike what was observed in the CVOTs, the study demonstrated no significant difference between drug classes with respect to development of the 3P-MACE outcomes. Future research will include additional validation studies with external validation, implementation studies, and further development of the tool for clinical use.
Douglas Einstadter, MD, MPH (Committee Chair)
76 p.
Endocrinology; Medicine
Precision medicine, diabetes, endocrinology, therapy, clinical tool

Recommended Citations

Citations

  • El Sanadi, C. E. (2020). DEVELOPMENT AND VALIDATION OF CLINICAL PREDICTION TOOLS FOR AIDING IN SELECTION OF 2ND LINE THERAPIES ADDED TO METFORMIN IN TREATMENT OF TYPE 2 DIABETES [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1607604907339227

    APA Style (7th edition)

  • El Sanadi, Caroline. DEVELOPMENT AND VALIDATION OF CLINICAL PREDICTION TOOLS FOR AIDING IN SELECTION OF 2ND LINE THERAPIES ADDED TO METFORMIN IN TREATMENT OF TYPE 2 DIABETES. 2020. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1607604907339227.

    MLA Style (8th edition)

  • El Sanadi, Caroline. "DEVELOPMENT AND VALIDATION OF CLINICAL PREDICTION TOOLS FOR AIDING IN SELECTION OF 2ND LINE THERAPIES ADDED TO METFORMIN IN TREATMENT OF TYPE 2 DIABETES." Doctoral dissertation, Case Western Reserve University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=case1607604907339227

    Chicago Manual of Style (17th edition)

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This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.