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The Joint Asia Diabetes Evaluation (JADE) Program: a web‐based program to translate evidence to clinical practice in Type 2 diabetes
Author(s) -
Chan J.,
So W.,
Ko G.,
Tong P.,
Yang X.,
Ma R.,
Kong A.,
Wong R.,
Le Coguiec F.,
Tamesis B.,
Wolthers T.,
Lyubomirsky G.,
Chow P.
Publication year - 2009
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2009.02751.x
Subject(s) - medicine , diabetes mellitus , jade (particle detector) , type 2 diabetes , prospective cohort study , cohort study , risk assessment , emergency medicine , endocrinology , physics , computer security , particle physics , computer science
Aims The Joint Asia Diabetes Evaluation (JADE) Program is the first web‐based program incorporating a comprehensive risk engine, care protocols, clinical decision and self‐management support to improve ambulatory diabetes care. The aim was to validate the risk stratification system of the JADE Program using a large prospective cohort. Methods The JADE interactive risk engine stratifies patients into different risk levels using results from an annual comprehensive assessment of complications and risk factors. We used a prospective registry consisting of 7534 Type 2 diabetic patients [45.6% men, median (range) age 57 years (13–92)] to perform internal validation of the risk engine. Results The JADE Risk Engine categorized patients into four risk levels (from low to high): level 1, n = 4520 (6%); level 2, n = 1468 (19.5%); level 3, n = 4476 (59.4%); and level 4, n = 1138 (15.1%). After a median follow‐up period of 5.5 years (mean ± sd 5.4 ± 2.81 years), 763 (10.1%) died, 1129 (14.9%) developed cardiovascular disease (CVD), 282 (3.7%) developed end‐stage renal disease and 1400 (18.6%) had at least one of these events. Compared with risk level 1, levels 2, 3 and 4 were associated with 2.8‐, 4.7‐ and 8.6‐fold increased risk of clinical end‐points. Risk levels 3 and 4 were, respectively, associated with 2.2‐ and 3.9‐fold increased risk for all‐cause death and 4.8‐ and 12.1‐fold increased CVD risks. Conclusion Based on results from a comprehensive assessment, the JADE Risk Engine successfully categorizes patients into different risk levels to guide clinical management.