Development and Internal Validation of the Multiethnic Type 2 Diabetes Outcomes Model for the U.S. (DOMUS)
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: The objective of this study was to develop and internally validate a mathematical model of the relationships between patient clinical and social risk factors and outcomes using data from a multiethnic population with type 2 diabetes. RESEARCH DESIGN AND METHODS: We constructed an incidence cohort of all adults (18 years or older) with newly diagnosed type 2 diabetes in the Kaiser Permanente Northern California (KPNC) health care system between 2005 and 2016 (n = 129,000), following patients for at least 1 year, but up to 12 years. Using this cohort, we modeled 17 distinct diabetes-related outcomes related to micro- and macrovascular disease, as well as atrial fibrillation, depression, dementia, relevant biomarkers, and mortality. RESULTS: Data were randomly split into 50%, 25%, and 25% samples to perform model estimation, calibration, and validation, respectively. Empirical and simulated data were similar for the events and biomarkers, but some factors required calibration. After calibration, they closely aligned with empirical estimates. CONCLUSIONS: The resulting Diabetes Outcome Model of the U.S. (DOMUS) is a major step forward in understanding diabetes progression and the role of social determinants of health. This model can be used by scientists, policymakers, and health system managers to better understand how choices can affect population health and health disparities, including the broad diversity of U.S. races and ethnicities. Moreover, this model can be used to realize longer-term comparative effectiveness in cost-effectiveness analyses for diabetes management in the future.
Source: Diabetes Care
DOI: 10.2337/dc25-0911
Authors: Aaron N. Winn, Zachary Newman, Amber Deckard, Melissa I. Franco-Galicia, Erin M. Staab, Monica E. Peek, Anirban Basu, Philip Clarke, Wen Wan, Elbert S. Huang, Andrew J. Karter, Donald Miller, M. Reza Skandari, Howard H. Moffet, Mengqi Zhu, Jennifer Y. Liu, Jyoti Sarker, Wael Mohammed, Robert Smith, Neda Laiteerapong
Institutions: University of Illinois Chicago, Emory University, Rush University Medical Center, Stanford University, University of Chicago, University of Washington, University of Oxford, Kaiser Permanente, Kaiser Permanente Northern California, Boston University, Imperial College London, University of Sheffield
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: American Diabetes Association, Novo Nordisk, National Institutes of Health, Chicago Center for Diabetes Translation Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Environmental Health Sciences, National Institute on Minority Health and Health Disparities, Division of Diabetes, Endocrinology, and Metabolic Diseases
OpenAlex ID: W4414498171