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---
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- title : " Changes to algorithm since original validation "
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+ title : " Changes to algorithm"
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output : rmarkdown::html_vignette
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bibliography : references.bib
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csl : vancouver.csl
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vignette : >
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- %\VignetteIndexEntry{Rationale }
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+ %\VignetteIndexEntry{Changes to algorithm }
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%\VignetteEngine{knitr::rmarkdown}
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%\VignetteEncoding{UTF-8}
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---
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In this vignette, you'll find a description of the changes that have
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been made to the OSDC algorithm since its [ original
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- validation] ( https://doi.org/10.2147/CLEP.S407019 ) . The algorithm has
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- been implemented with these changes in the ` osdc ` package. In addition ,
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- potential changes that might be implemented in the ` osdc ` package in the
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- future are described. When an update to the algorithm has been
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- implemented, this vignette will also provide validation metrics for that
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- version of the algorithm and track its validity across versions.
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+ validation] ( https://doi.org/10.2147/CLEP.S407019 ) . The osdc package uses
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+ the latest changes to the algorithm. Potential changes to the algorithm ,
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+ rather than the specific implementation and code details, that we might
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+ in the future will also be described in this vignette. We will also
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+ provide validation metrics here whenever we make a change, and track
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+ these validations over the different versions.
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- ## Changes since original validation
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+ ## Specific changes
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- 1 . Purchases of semaglutid, dapagliflozin or empagliflozin are no
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- longer used, neither for inclusion events nor classification of
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+ ### Since the original published validation (version 1)
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+
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+ 1 . We don't use purchases of semaglutid, dapagliflozin or
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+ empagliflozin, neither for inclusion events nor classification of
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diabetes type (due to increasing use in treatment of non-diabetes).
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- 2 . Diabetes type reclassification based on insulin purchases in the
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- previous year is no longer used .
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+ 2 . We no longer use diabetes type reclassification based on insulin
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+ purchases in the previous year .
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## Validity
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- Algorithm validity across versions. Reports ` PPV ` : * positive predictive
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- value* and ` Sens ` : * sensitivity* overall and among cases with atypical
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- age at onset of T1D (after age 40) and T2D (before age 40),
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- respectively.
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-
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- - Paper:
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- - T1D:
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- - PPV: 0.943
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- - Sens: 0.773
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- - T1D \> 40:
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- - PPV: 0.708
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- - Sens: 0.378
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- - T2D:
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- - PPV: 0.875
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- - Sens: 0.944
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- - T2D\< 40:
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- - PPV: 0.471
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- - Sens: 0.863
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-
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- ## Future potential changes
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+ Algorithm validity across versions. Reports ` PPV ` (* positive predictive
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+ value* ) and ` sensitivity ` among cases with atypical age at onset of T1D
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+ (after age 40) and T2D (before age 40), respectively.
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+
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+ | Version | Diabetes type | PPV | Sensitivity |
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+ | ---------| ---------------| -------| -------------|
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+ | 1 | T1D | 0.943 | 0.773 |
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+ | 1 | T1D \> 40 yrs | 0.708 | 0.378 |
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+ | 1 | T2D | 0.875 | 0.944 |
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+ | 1 | T2D \< 40 yrs | 0.471 | 0.863 |
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+
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+ ## Potential future changes
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1 . Add support for using medical birth register to define pregnancies
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to censor gestational diabetes (GDM). This will allow for the
@@ -56,8 +50,8 @@ respectively.
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to), and enable the extension of the window of valid dates of
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diagnosis to 1996 onward.
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2 . Simplify logic defining pregnancy index dates to remove dependency
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- on maternal care visits (if performance in validation allows)
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+ on maternal care visits (if performance in validation allows).
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3 . Limit the historic scope of primary diagnoses used to evaluate
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majority of diabetes-specific diagnoses in type classification (e.g.
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only evaluate majority among the last five type-specific diabetes
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- diagnoses)
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+ diagnoses).
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