Diabetes Mellitus, Type 2NCT02140645
Ascertainment of EMR-based Clinical Covariates Among Patients Receiving Oral and Non-insulin Injected Hypoglycemic Therapy
An observational study of Diabetes Mellitus, Type 2, run by Boehringer Ingelheim at 1 site in United States.
Trial summary
The objective of this study is to identify EMR-based clinical covariates and quantify their association with the prescribing of each specific type 2 diabetes (T2DM) medication under investigation. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Diabetes Mellitus, Type 2
- What is being tested?
- linagliptin
- How many people
- 166,613 participants
- Where
- 1 siteUnited States
- Study dates
- May 2014to Mar 2015
- Phase
- Observational
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: T2DM patients aged 18 or older, initiating antidiabetic treatment after at least 6 months of continuous enrollment
Who may be able to join
- Dispensing of an oral or non-insulin injected hypoglycemic medication between May 2011 and June 2012
- Diagnosis of type 2 diabetes mellitus
- Presence of electronic medical records (for the EMR-based subset)
Who cannot join
- Age <18 at T2DM medication initiation
- Missing or ambiguous age or sex information
- At least one diagnosis of type 1 diabetes mellitus
- Less than 6 months enrolment in the database preceding the date of the first dispensing
- Prior use of the index drug
Trial locations and contacts
1 site in 1 country.
United States1 site
Boehringer Ingelheim Investigational Site
Boston, Massachusetts
About this study
Official title: Association of Clinical Covariates With Non-insulin Diabetes Medication Initiation Using Electronic Medical Records (EMR)
The objective of this study is to identify EMR-based clinical covariates and quantify their association with the prescribing of each specific type 2 diabetes (T2DM) medication under investigation. This will include an assessment of how well these covariates are captured through claims data proxies, and their potential to confound comparative research of T2DM medications.
Read the detailed description
Purpose:
- Conditions
- Diabetes Mellitus, Type 2
- Being tested
- linagliptin
- Medical subject headings
- Diabetes Mellitus, Type 2
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
linagliptinDrug
non-randomized
| Study group | Role | What they receive |
|---|---|---|
| Linagliptin1 | T2DM patients initiating Linagliptin (DPP-4 comparison) Receives: Drug: linagliptin | |
| Other DPP4 | T2DM patients initiating a non-linagliptin DPP-4 inhibitor | |
| Linagliptin2 | T2DM patients initiating Linagliptin (glitizaone comparison) | |
| Glitazones | T2DM patients initiating Thiazolidinediones (glitazones) | |
| Sulfonylurea | T2DM patients initiating any medication in the Sulfonylurea class | |
| Linagliptin3 | T2DM patients initiating Linagliptin (Sulfonylurea comparison) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Missing EMR (Electronic Medical Record) Characteristic: Smoking
The missing EMR characteristic smoking defined as current, unknown, versus past/never smoker.
The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic smoking was the dependent variable and all claims-based covariates were included as independent variables.
The estimated value represented is actually prediction accuracy defined by C-statistics.
Measured: Up to 20 months
Missing EMR Characteristic: Duration of Diabetes
The missing EMR characteristic duration of diabetes defined as >7, 5-6, 3-5, 1-3, <1 (in years) in duration.
The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic duration of diabetes was the dependent variable and all claims-based covariates were included as independent variables.
The estimated value represented is actually prediction accuracy defined by C-statistics.
Measured: Up to 20 months
Missing EMR Characteristic: Duration of Diabetes (Continuous)
The missing EMR characteristic duration of diabetes defined as starting year/starting age of diabetes.
Linear regression models were ran using a prioritized list of claims-based covariates as predictors and the value of select EMR-based clinical characteristics duration of diabetes as continuous outcomes.
The estimated value represented is actually prediction accuracy defined by R-squared.
Measured: Up to 20 months
Missing EMR Characteristic: BMI (Body Mass Index)
The missing EMR characteristic BMI defined as not obese, overweight, obese, severe obesity.
The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic BMI was the dependent variable and all claims-based covariates were included as independent variables.
The estimated value represented is actually prediction accuracy defined by C-statistics.
Measured: Up to 20 months
Missing EMR Characteristic: BMI (Continuous)
The missing EMR characteristic BMI is BMI value. Linear regression models were ran using a prioritized list of claims-based covariates as predictors and the value of select EMR-based clinical characteristics BMI as continuous outcomes.
The estimated value represented is actually prediction accuracy defined by R-squared.
Measured: Up to 20 months
Missing EMR Characteristic: HbA1c (Hemoglobin A1c (Glycosylated Hemoglobin))
The missing EMR characteristic HbA1c defined as value in 6 months prior to and including index date.
The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic HbA1c was the dependent variable and all claims-based covariates were included as independent variables.
The estimated value represented is actually prediction accuracy defined by C-statistics.
Measured: Up to 20 months
Missing EMR Characteristic: eGFR (Glomerular Filtration Rate)
The missing EMR characteristic eGFR defined as value in 6 months prior to and including index date.
The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic eGFR was the dependent variable and all claims-based covariates were included as independent variables.
The estimated value represented is actually prediction accuracy defined by C-statistics.
Measured: Upto 20 months
Missing EMR Characteristic: Total Cholesterol
The missing EMR characteristic total cholesterol defined as value in 6 months prior to and including index date.
The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic total cholesterol was the dependent variable and all claims-based covariates were included as independent variables.
The estimated value represented is actually prediction accuracy defined by C-statistics.
Measured: Up to 20 months
Missing EMR Characteristic: Systolic BP (Blood Pressure)
The missing EMR characteristic systolic BP defined as value in 6 months prior to and including index date.
The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic systolic BP was the dependent variable and all claims-based covariates were included as independent variables.
The estimated value represented is actually prediction accuracy defined by C-statistics.
Measured: Up to 20 months
Missing EMR Characteristic: Diastolic BP
The missing EMR characteristic diastolic BP defined as value in 6 months prior to and including index date.
The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic diastolic BP was the dependent variable and all claims-based covariates were included as independent variables.
The estimated value represented is actually prediction accuracy defined by C-statistics.
Measured: Up to 20 months
Binary EMR Characteristic: Neuropathy
The missing EMR characteristic neuropathy defined as participants with any note of diabetic neuropathy.
The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic neuropathy was the dependent variable and all claims-based covariates were included as independent variables.
The estimated value represented is actually prediction accuracy defined by C-statistics.
Measured: Up to 20 months
Binary EMR Characteristic: Nephropathy
The missing EMR characteristic nephropathy defined as participants with any note of diabetic nephropathy.
The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic nephropathy was the dependent variable and all claims-based covariates were included as independent variables.
The estimated value represented is actually prediction accuracy defined by C-statistics.
Measured: Upto 20 months
Binary EMR Characteristic: Retinopathy
The missing EMR characteristic retinopathy defined as participants with any note of diabetic retinopathy.
The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic retinopathy was the dependent variable and all claims-based covariates were included as independent variables.
The estimated value represented is actually prediction accuracy defined by C-statistics.
Measured: Up to 20 months
Binary EMR Characteristic: Pancreatitis
The missing EMR characteristic pancreatitis defined as participants with any note of prior pancreatitis.
The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic pancreatitis was the dependent variable and all claims-based covariates were included as independent variables.
The estimated value represented is actually prediction accuracy defined by C-statistics.
Measured: Up to 20 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 May 2014 (estimated)
- Study startMay 2014
- Primary completionMar 2015
- Study completionMar 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Diabetes Mellitus, Type 2Studies of the same condition, open and under way.
- More trials run by Boehringer IngelheimThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Retrospective
- Enrolment
- 166,613 participants (actual)
Sponsor and investigators
- Lead sponsor
- Boehringer Ingelheim
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Eli Lilly and Company
- Responsible party
- Sponsor
- Investigators
- Boehringer Ingelheim, Study chair, Boehringer Ingelheim
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02140645
- Sponsor's protocol ID
- 1218.162
- Status last verified
- Dec 2016
- First submitted
- 14 May 2014
- Last updated
- 8 Feb 2017
- Results posted
- Yes, on ClinicalTrials.gov
Study at a glance
From the registry record, last updated by the sponsor on 8 Feb 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Association of Clinical Covariates With Non-insulin Diabetes Medication Initiation Using Electronic Medical Records (EMR)
- ClinicalTrials.gov ID
- NCT02140645
- Acronym / sponsor ID
- 1218.162
- Conditions
- Diabetes Mellitus, Type 2
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 166,613 participants (actual)
- Lead sponsor
- Boehringer IngelheimIndustry (pharma, biotech, devices)
- Collaborators
- Eli Lilly and Company
- Study start
- May 2014
- Primary completion
- Mar 2015 (actual)
- Study completion
- Mar 2015 (actual)
- First posted
- 16 May 2014 (estimated)
- Results
- Posted 8 Feb 2017
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The objective of this study is to identify EMR-based clinical covariates and quantify their association with the prescribing of each specific type 2 diabetes (T2DM) medication under investigation. This will include an assessment of how well these covariates are captured through claims data proxies, and their potential to confound comparative research of T2DM medications.
Detailed description
Purpose:
Study design
- Observational model
- Cohort
- Time perspective
- Retrospective
- Number of arms
- 6
| Arm | Type | Receives |
|---|---|---|
| Linagliptin1 | – | Drug: linagliptinT2DM patients initiating Linagliptin (DPP-4 comparison) |
| Other DPP4 | – | –T2DM patients initiating a non-linagliptin DPP-4 inhibitor |
| Linagliptin2 | – | –T2DM patients initiating Linagliptin (glitizaone comparison) |
| Glitazones | – | –T2DM patients initiating Thiazolidinediones (glitazones) |
| Sulfonylurea | – | –T2DM patients initiating any medication in the Sulfonylurea class |
| Linagliptin3 | – | –T2DM patients initiating Linagliptin (Sulfonylurea comparison) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- T2DM patients aged 18 or older, initiating antidiabetic treatment after at least 6 months of continuous enrollment
Key inclusion criteria (3 listed)
- Dispensing of an oral or non-insulin injected hypoglycemic medication between May 2011 and June 2012
- Diagnosis of type 2 diabetes mellitus
- Presence of electronic medical records (for the EMR-based subset)
Key exclusion criteria (5 listed)
- Age <18 at T2DM medication initiation
- Missing or ambiguous age or sex information
- At least one diagnosis of type 1 diabetes mellitus
- Less than 6 months enrolment in the database preceding the date of the first dispensing
- Prior use of the index drug
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| linagliptinnon-randomized | Drug | Linagliptin1 |
Primary outcome
Missing EMR (Electronic Medical Record) Characteristic: Smoking
Time frame: Up to 20 months
The missing EMR characteristic smoking defined as current, unknown, versus past/never smoker. The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic smoking was the dependent variable and all claims-based covariates were included as independent variables. The estimated value represented is actually prediction accuracy defined by C-statistics.
Missing EMR Characteristic: Duration of Diabetes
Time frame: Up to 20 months
The missing EMR characteristic duration of diabetes defined as >7, 5-6, 3-5, 1-3, <1 (in years) in duration. The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic duration of diabetes was the dependent variable and all claims-based covariates were included as independent variables. The estimated value represented is actually prediction accuracy defined by C-statistics.
Missing EMR Characteristic: Duration of Diabetes (Continuous)
Time frame: Up to 20 months
The missing EMR characteristic duration of diabetes defined as starting year/starting age of diabetes. Linear regression models were ran using a prioritized list of claims-based covariates as predictors and the value of select EMR-based clinical characteristics duration of diabetes as continuous outcomes. The estimated value represented is actually prediction accuracy defined by R-squared.
Missing EMR Characteristic: BMI (Body Mass Index)
Time frame: Up to 20 months
The missing EMR characteristic BMI defined as not obese, overweight, obese, severe obesity. The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic BMI was the dependent variable and all claims-based covariates were included as independent variables. The estimated value represented is actually prediction accuracy defined by C-statistics.
Missing EMR Characteristic: BMI (Continuous)
Time frame: Up to 20 months
The missing EMR characteristic BMI is BMI value. Linear regression models were ran using a prioritized list of claims-based covariates as predictors and the value of select EMR-based clinical characteristics BMI as continuous outcomes. The estimated value represented is actually prediction accuracy defined by R-squared.
Missing EMR Characteristic: HbA1c (Hemoglobin A1c (Glycosylated Hemoglobin))
Time frame: Up to 20 months
The missing EMR characteristic HbA1c defined as value in 6 months prior to and including index date. The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic HbA1c was the dependent variable and all claims-based covariates were included as independent variables. The estimated value represented is actually prediction accuracy defined by C-statistics.
Missing EMR Characteristic: eGFR (Glomerular Filtration Rate)
Time frame: Upto 20 months
The missing EMR characteristic eGFR defined as value in 6 months prior to and including index date. The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic eGFR was the dependent variable and all claims-based covariates were included as independent variables. The estimated value represented is actually prediction accuracy defined by C-statistics.
Missing EMR Characteristic: Total Cholesterol
Time frame: Up to 20 months
The missing EMR characteristic total cholesterol defined as value in 6 months prior to and including index date. The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic total cholesterol was the dependent variable and all claims-based covariates were included as independent variables. The estimated value represented is actually prediction accuracy defined by C-statistics.
Missing EMR Characteristic: Systolic BP (Blood Pressure)
Time frame: Up to 20 months
The missing EMR characteristic systolic BP defined as value in 6 months prior to and including index date. The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic systolic BP was the dependent variable and all claims-based covariates were included as independent variables. The estimated value represented is actually prediction accuracy defined by C-statistics.
Missing EMR Characteristic: Diastolic BP
Time frame: Up to 20 months
The missing EMR characteristic diastolic BP defined as value in 6 months prior to and including index date. The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic diastolic BP was the dependent variable and all claims-based covariates were included as independent variables. The estimated value represented is actually prediction accuracy defined by C-statistics.
Binary EMR Characteristic: Neuropathy
Time frame: Up to 20 months
The missing EMR characteristic neuropathy defined as participants with any note of diabetic neuropathy. The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic neuropathy was the dependent variable and all claims-based covariates were included as independent variables. The estimated value represented is actually prediction accuracy defined by C-statistics.
Binary EMR Characteristic: Nephropathy
Time frame: Upto 20 months
The missing EMR characteristic nephropathy defined as participants with any note of diabetic nephropathy. The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic nephropathy was the dependent variable and all claims-based covariates were included as independent variables. The estimated value represented is actually prediction accuracy defined by C-statistics.
Binary EMR Characteristic: Retinopathy
Time frame: Up to 20 months
The missing EMR characteristic retinopathy defined as participants with any note of diabetic retinopathy. The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic retinopathy was the dependent variable and all claims-based covariates were included as independent variables. The estimated value represented is actually prediction accuracy defined by C-statistics.
Binary EMR Characteristic: Pancreatitis
Time frame: Up to 20 months
The missing EMR characteristic pancreatitis defined as participants with any note of prior pancreatitis. The associations between claims-based covariates and missingness on EMR characteristics were investigated by estimating a logistic regression model (and multinomial logistic regression, depending on the number of categories for the EMR characteristic) for each EMR characteristic where an indicator for missing the EMR characteristic pancreatitis was the dependent variable and all claims-based covariates were included as independent variables. The estimated value represented is actually prediction accuracy defined by C-statistics.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Feb 2017.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Related InfoLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Boehringer Ingelheim study chair
Boehringer Ingelheim
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Diabetes Mellitus, Type 2, run by Boehringer Ingelheim at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Feb 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 8 Feb 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Missing EMR (Electronic Medical Record) Characteristic: Smoking (time frame: Up to 20 months). The study lists 14 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Feb 2017; AzTrials last refreshed its copy on 8 Nov 2026.