Li PI, Guo HR. Long-term quality-of-care score for predicting the occurrence of acute myocardial infarction in patients with type 2 diabetes mellitus. World J Diabetes 2023; 14(7): 1091-1102 [PMID: 37547581 DOI: 10.4239/wjd.v14.i7.1091]
Corresponding Author of This Article
How-Ran Guo, ScD, MD, MPH, Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, No. 138 Sheng-Li Road, Tainan 704, Taiwan. hrguo@mail.ncku.edu.tw
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Retrospective Cohort Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jul 15, 2023 (publication date) through Mar 12, 2026
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Journal Information of This Article
Publication Name
World Journal of Diabetes
ISSN
1948-9358
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Li PI, Guo HR. Long-term quality-of-care score for predicting the occurrence of acute myocardial infarction in patients with type 2 diabetes mellitus. World J Diabetes 2023; 14(7): 1091-1102 [PMID: 37547581 DOI: 10.4239/wjd.v14.i7.1091]
World J Diabetes. Jul 15, 2023; 14(7): 1091-1102 Published online Jul 15, 2023. doi: 10.4239/wjd.v14.i7.1091
Long-term quality-of-care score for predicting the occurrence of acute myocardial infarction in patients with type 2 diabetes mellitus
Pi-I Li, How-Ran Guo
Pi-I Li, Department of Family Medicine, Chi Mei Medical Center, Tainan 710, Taiwan
Pi-I Li, Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan
How-Ran Guo, Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
How-Ran Guo, Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan 704, Taiwan
Author contributions: Li PI and Guo HR conceived and designed the study; Li PI obtained and analyzed the data, and drafted the manuscript; Guo HR supervised the data analysis and helped interpretation of the results; Guo HR edited and revised the manuscript; both authors critically reviewed the manuscript and have approved the final version.
Supported bythe Chi-Mei Medical Center, No. CMNCKU10214 and No. CMFHR112027.
Institutional review board statement: The study was reviewed and approved for publication by the institutional review board of the Chi-Mei Medical Center (Approval No. 10207-E01).
Informed consent statement: The medical center removed personal identifying information from the medical records before releasing them and the informed consent was waived by the institutional review board of the Chi Mei Medical Center.
Conflict-of-interest statement: All authors have no conflict of interest related to the manuscript.
Data sharing statement: This study is based in part on the data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health and managed by National Health Research Institutes. The original anonymous dataset is available upon approval of the organization and with a fee.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Corresponding author: How-Ran Guo, ScD, MD, MPH, Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, No. 138 Sheng-Li Road, Tainan 704, Taiwan. hrguo@mail.ncku.edu.tw
Received: January 10, 2023 Peer-review started: January 10, 2023 First decision: January 31, 2023 Revised: February 20, 2023 Accepted: May 17, 2023 Article in press: May 17, 2023 Published online: July 15, 2023 Processing time: 184 Days and 1 Hours
ARTICLE HIGHLIGHTS
Research background
Cardiovascular disease (CVD) is the leading cause of death globally and diabetes mellitus (DM) is a well-established risk factor. Of the fatal outcomes of CVD, acute myocardial infarction (AMI) is the most common.
Research motivation
DM is a major modifiable factor for CVD, and good quality of care can reduce the risk of AMI in patients with DM. Therefore, a long-term quality-of-care score for DM may predict the occurrence of AMI among patients with type 2 DM and thus guide the care.
Research objectives
To develop a long-term quality-of-care score for predicting the occurrence of AMI among patients with type 2 DM.
Research methods
Using Taiwan’s Longitudinal Cohort of Diabetes Patients Database and the medical charts of a medical center, we identified incident patients diagnosed with type 2 DM. We constructed a summary quality-of-care score consists of process indicators, intermediate outcome indicators, and a hallmark co-morbidity. The associations between the score and the incidence of AMI were evaluated using Cox regression models.
Research results
A total of 7351 patients were enrolled. In comparison with participants who had scores ≤ 1, those with scores between 2 and 4 had a lower risk of developing AMI [adjusted hazard ratio (AHR) = 0.71; 95% confidence interval (95%CI): 0.55-0.90], and those with scores ≥ 5 had an even lower risk (AHR = 0.37; 95%CI: 0.21-0.66). The performance of this score in predicting the risk of AMI is better than that of a widely used scoring system.
Research conclusions
Good quality of care can reduce the risk of AMI in patients with type 2 DM. The quality-of-care score developed in this study had a significant association with the risk of AMI and thus can be applied to guiding the care for these patients.
Research perspectives
The quality-of-care score developed in this study can be applied to guiding the care for these patients, but different healthcare systems may make modifications to the scoring system for better application.
