Lessons from TuAnalyze: January 2011
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Transcript of Lessons from TuAnalyze: January 2011
PHIConnect CDC Center of Excellence in Public Health Informatics
The TuAnalyze project
Mission -‐-‐ To empower people touched by diabetes to track, share and compare their health informa=on for research advancing diabetes care and public health response
TuAnalyze is a so.ware “app” developed for TuDiabetes
TuAnalyze launched May 2010 in English, December 2010 in Spanish
TuAnalyze supports reporEng & sharing of diabetes informaEon
Data are used in aggregate community reports, in charts and maps generated for the community, and in public health research
The project is led by faculty from Children’s Hospital Boston and Harvard Medical School in collaboraEon with the Diabetes Hands FoundaEon, with funding from the US Centers for Disease Control and PrevenEon
In collaboration with:
PHIConnect CDC Center of Excellence in Public Health Informatics
Early results: Who’s using TuAnalyze?
So far 20 US states and 2 Canadian provinces have reported enough A1c values to “light up” these map regions
ArgenEna, Spain, Great Britain and several Mexican states are geQng close.
1 in 10 TuDiabetes members using TuAnalyze (about 1700 users)
Users from 43 countries and all 50 US states are parEcipaEng
In collaboration with:
PHIConnect CDC Center of Excellence in Public Health Informatics
Glycemic control in the community TuAnalyze is the first online social network based repor=ng
system for A1c—a key measure of diabetes control
The average A1c of TuAnalyze users is 6.9%
A1c ranges from 4.0% to 13.7%
0%
5%
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35%
40%
5% or lower 6% 7% 8% 9% 10% 11% 12% or higher
% of Total
A1c Value Among 1453 Users
Frequency Distribu=on of A1c% Among TuAnalyze Users
In collaboration with:
PHIConnect CDC Center of Excellence in Public Health Informatics
Glycemic control in the community Most users (> 80%) are reporEng current A1c values
As app use has increased, users with a wider range of A1c have begun parEcipaEng—providing a more complete picture
1 of 4 users have entered more than one A1c into TuAnalyze
Users who are updaEng their A1cs with new values are, on average, reporEng lower A1c values over Eme
August 2010 December 2010 May 2010
In collaboration with:
PHIConnect CDC Center of Excellence in Public Health Informatics
US na=onal comparison Among users with diagnosed diabetes, the average A1c reported by US
TuAnalyze users is lower than the average A1c esEmated from a US naEonal health reporEng system* (avg. A1c respecEvely, 6.7% vs. 7.3%)
A close look shows different A1c distribuEon in the two groups
0%
5%
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40%
45%
5% or lower 6% 7% 8% 9% 10% 11% 12% or higher
Percen
t of total with given A1c
Rounded A1c 340 par=cpants from TuAnalyze and 704 from NHANES
TuAnalyze
NHANES
In collaboration with: *2007-‐08 NaEonal Health and NutriEon
ExaminaEon Survey (NHANES)
PHIConnect CDC Center of Excellence in Public Health Informatics
TuAnalyze survey
Among this group: 60% are female
Average age is 44, age ranges from 14-‐81
Average A1c is 6.75%
A1c does not differ by age, diabetes type, or by dura5on of diagnosis Type 1
62.7%
Type 2 26.1%
LADA 10.5%
Pre-‐Diabetes 0.7%
Diabetes Type Among Survey Par=cipants
Among 437 Survey ParEcipants
In collaboration with:
1 in 3 TuAnalyze users has taken the 1st TuAnalyze survey, so far!
PHIConnect CDC Center of Excellence in Public Health Informatics
Type 1 Diabetes Average:
• A1c 6.75% • Age: 42 • Age at diagnosis: 17
74% use a pump Most important treatment:
• Pump (70%) • InjecEons (23%)
Type 2 Diabetes Average:
• A1c 6.77% • Age: 52 • Age at diagnosis: 44
48% on insulin; 23% of those use a pump Most important treatment:
• Diet (39%) • Insulin injecEons (25%) LADA Diabetes
Average: • A1c 6.8% • Age: 51 • Age at diagnosis: 40
69% use a pump Most important treatment:
• Insulin pump (61%) • Insulin injecEons (28%)
In collaboration with:
PHIConnect CDC Center of Excellence in Public Health Informatics
Caregivers in TuAnalyze
8% of survey par=cipants use the TuAnalyze applica=on on behalf of a loved one with diabetes
89% of them are using the applicaEon for a child
60% spend at least 7 hours per week helping with their loved one’s diabetes care
91% are the primary medical liaison for their loved one
In collaboration with:
PHIConnect CDC Center of Excellence in Public Health Informatics
32% of survey parEcipants report obtaining all five recommended care pracEces
44.6%
68.7%
90.2% 86.0%
69.1%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
100%
% of Survey Respondents who Follow ADA Care Guidelines*
* The American Diabetes AssociaEon recommends that all persons with diabetes receive a yearly flu vaccinaEon, cholesterol check, foot exam, dilated eye exam, and a one-‐Eme pneumonia vaccinaEon.
Preven=ve Care
In collaboration with:
PHIConnect CDC Center of Excellence in Public Health Informatics
64.8%
47.7% 50.6%
31.6%
50.1%
0%
10%
20%
30%
40%
50%
60%
70%
% of S
urvey Re
spon
dents
Care Behavior
Frequency of Care Behaviors
Check their blood glucose 5+ Emes per day
Check their blood glucose before driving
Saw a DNE in the last year
Saw a nutriEonist in the last year
Saw their diabetes physican 4+ Emes in the last year
Self-‐Care Behaviors and Medical Visits
In collaboration with:
PHIConnect CDC Center of Excellence in Public Health Informatics
Challenges in the Community
8.9%
37.5%
14.9%
28.2%
19.7%
37.1%
0%
5%
10%
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40%
Frequency of Health Challenges in the Survey Popula=on
% of survey respondents
2 of 3 survey respondents report at least one challenge
In collaboration with:
PHIConnect CDC Center of Excellence in Public Health Informatics
What’s Next?
Brief, targeted surveys on specific topics, such as:
• ConEnuous Glucose Monitoring
• Pump and device use
• Hypoglycemia
• Women’s reproducEve health and diabetes
In collaboration with:
Thank you to everyone who has par=cipated in TuAnalyze! By contribu=ng your data, you have provided an invaluable
window into the TuDiabetes community.
Our research is ongoing: if you haven’t yet used TuAnalyze, we invite you to join, enter your A1c and take the survey at hkp://tud4.us/TuAnalyzeProfile .