Individual Risk Patient Predictions

MWDH have developed a number of predictive analytics using data from large cohort in Scotland and revalidated in London to cover a wider ethnic mix. These predict major macrovascular and microvascular complications of diabetes and other events. The number of model available will increase over time as the system develops and we will continue to revalidate models in wider data sets / geographies of deployment going forward.

The models may perform slightly differently to other models that you are familiar with like Q RISK (which can be accessed from the medication response page given they use different inputs and endpoints. We encourage you to continue to use these additional tools if a guideline specifically recommends that.

As with other decision support, these predictions are an aid and should not replace clinical decision making, which should make use of all the information available (noting that models only work off a limited data set). 

**Also note for amputation and blindness predictions – these are rare end points, so prediction %’s may be low; do not be falsely reassured that the patient is not at risk of developing progressing towards earlier events such as retinopathy or foot ulcers.

Video of how risk prediction tool works

Model approach and input features

For information, the complications prediction models use a ‘metamodel’ approach, making use of these input features:

1. Time to the beginning of the prediction window
2. Time to the end of the prediction window
3. Age at diagnosis
4. Duration of diabetes
5. Ethnicity
6. Male/Female
7. Current (most recent) Body Mass Index
8. HbA1c: mean of all recorded values in the last 2 years
9. HbA1c: current (most recent) value
10. Systolic Blood Pressure: mean of all recorded values in the last 2 years
11. Systolic Blood Pressure: current (most recent) value
12. Current (most recent) high-density lipoprotein
13. Current (most recent) low-density lipoprotein
14. Current ratio of total to HDL cholesterol
15. Current (most recent) estimated glomerular filtration rate
16. Current (most recent) urine albumin-creatinine ratio
17. History of cardiovascular disease
18. History of peripheral vascular disease
19. History of Blindness in either eye
20. History of congestive heart failure
21. History of ischemic heart disease
22. History of micro or macro albuminuria
23. History of amputation
24. History of stroke
25. Current smoking status
26. Past smoking status