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dc.contributor.authorMunshi, Viditen_US
dc.contributor.authorSaghafian, Soroushen_US
dc.contributor.authorCook, Curtissen_US
dc.contributor.authorAradhyula, Sumhithen_US
dc.contributor.authorChakkera, Harinien_US
dc.date2021-01-07
dc.date.accessioned2021-04-26T17:51:11Z
dc.date.available2021-04-26T17:51:11Z
dc.date.issued2021-03
dc.identifier.citationVidit Munshi, Soroush Saghafian, Curtiss Cook, Sumhith Aradhyula, Harini Chakkera. 2021. "Use of Imputation and Decision Modeling to Improve Diagnosis and Management of Patients at Risk for New-Onset Diabetes After Transplantation." Annals of transplantation: quarterly of the Polish Transplantation Society, https://doi.org/10.12659/AOT.928624
dc.identifier.issn2329-0358
dc.identifier.urihttps://hdl.handle.net/2144/42413
dc.description.abstractBACKGROUND New-onset diabetes after transplantation (NODAT) is a complication of solid organ transplantation. We sought to determine the extent to which NODAT goes undiagnosed over the course of 1 year following transplantation, analyze missed or later-diagnosed cases of NODAT due to poor hemoglobin A1c (HbA1c) and fasting blood glucose (FBG) collection, and to estimate the impact that improved NODAT screening metrics may have on long-term outcomes. MATERIAL AND METHODS This was a retrospective study utilizing 3 datasets from a single center on kidney, liver, and heart transplantation patients. Retrospective analysis was supplemented with an imputation procedure to account for missing data and project outcomes under perfect information. In addition, the data were used to inform a simulation model used to estimate life expectancy and cost-effectiveness of a hypothetical intervention. RESULTS Estimates of NODAT incidence increased from 27% to 31% in kidney transplantation patients, from 31% to 40% in liver transplantation patients, and from 45% to 67% in heart transplantation patients, when HbA1c and FBG were assumed to be collected perfectly at all points. Perfect screening for kidney transplantation patients was cost-saving, while perfect screening for liver and heart transplantation patients was cost-effective at a willingness-to-pay threshold of $100 000 per life-year. CONCLUSIONS Improved collection of HbA1c and FBG is a cost-effective method for detecting many additional cases of NODAT within the first year alone. Additional research into both improved glucometric monitoring as well as effective strategies for mitigating NODAT risk will become increasingly important to improve health in this population.en_US
dc.language.isoen_US
dc.publisherInternational Scientific Information, Inc.en_US
dc.relation.ispartofAnnals of transplantation: quarterly of the Polish Transplantation Society
dc.subjectSurgeryen_US
dc.subjectClinical sciencesen_US
dc.titleUse of imputation and decision modeling to improve diagnosis and management of patients at risk for new-onset diabetes after transplantationen_US
dc.typeArticleen_US
dc.description.versionAccepted manuscripten_US
dc.identifier.doi10.12659/AOT.928624
pubs.elements-sourcemanual-entryen_US
pubs.notesEmbargo: 12 monthsen_US
pubs.organisational-groupBoston Universityen_US
pubs.organisational-groupBoston University, Questrom School of Businessen_US
pubs.organisational-groupBoston University, Questrom School of Business, Markets, Public Policy & Lawen_US
pubs.publication-statusAccepteden_US
dc.identifier.mycv594617


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