A Meta-Analysis of the Relative Risk of Mortality for Type 1 Diabetes Patients Compared to the General Population: Exploring Temporal Changes in Relative Mortality
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{"title"=>"A Meta-Analysis of the Relative Risk of Mortality for Type 1 Diabetes Patients Compared to the General Population: Exploring Temporal Changes in Relative Mortality", "type"=>"journal", "authors"=>[{"first_name"=>"Tom W. C.", "last_name"=>"Lung"}, {"first_name"=>"Alison J.", "last_name"=>"Hayes"}, {"first_name"=>"William H.", "last_name"=>"Herman"}, {"first_name"=>"Lei", "last_name"=>"Si"}, {"first_name"=>"Andrew J.", "last_name"=>"Palmer"}, {"first_name"=>"Philip M.", "last_name"=>"Clarke"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"1932-6203", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)", "pmid"=>"25426948", "doi"=>"10.1371/journal.pone.0113635"}, "id"=>"57ad46e2-dfe4-3fcc-9dba-0a6c87624673", "abstract"=>"AIMS: Type 1 diabetes has been associated with an elevated relative risk (RR) of mortality compared to the general population. To review published studies on the RR of mortality of Type 1 diabetes patients compared to the general population, we conducted a meta-analysis and examined the temporal changes in the RR of mortality over time.\\n\\nMETHODS: Systematic review of studies reporting RR of mortality for Type 1 diabetes compared to the general population. We conducted meta-analyses using a DerSimonian and Laird random effects model to obtain the average effect and the distribution of RR estimates. Sub-group meta-analyses and multivariate meta-regression analysis was performed to examine heterogeneity. Summary RR with 95% CIs was calculated using a random-effects model.\\n\\nRESULTS: 26 studies with a total of 88 subpopulations were included in the meta-analysis and overall RR of mortality was 3.82 (95% CI 3.41, 3.4.29) compared to the general population. Observations using data prior to 1971 had a much larger estimated RR (5.80 (95% CI 4.20, 8.01)) when compared to: data between; 1971 and 1980 (5.06 (95% CI 3.44, 7.45)); 1981-90 (3.59 (95% CI 3.15, 4.09)); and those after 1990 (3.11 (95% CI 2.47, 3.91)); suggesting mortality of Type 1 diabetes patients when compared to the general population have been improving over time. Similarly, females (4.54 (95% CI 3.79-5.45)) had a larger RR estimate when compared to males (3.25 (95% CI 2.82-3.73) and the meta-regression found evidence for temporal trends and sex (p<0.01) accounting for heterogeneity between studies.\\n\\nCONCLUSIONS: Type 1 diabetes patients' mortality has declined at a faster rate than the general population. However, the largest relative improvements have occurred prior to 1990. Emphasis on intensive blood glucose control alongside blood pressure control and statin therapy may translate into further reductions in mortality in coming years.", "link"=>"http://www.mendeley.com/research/metaanalysis-relative-risk-mortality-type-1-diabetes-patients-compared-general-population-exploring", "reader_count"=>23, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>3, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>1, "Student > Master"=>5, "Other"=>3, "Student > Bachelor"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>3, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>1, "Student > Master"=>5, "Other"=>3, "Student > Bachelor"=>1, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Biochemistry, Genetics and Molecular Biology"=>1, "Medicine and Dentistry"=>13, "Agricultural and Biological Sciences"=>2, "Neuroscience"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Psychology"=>1, "Social Sciences"=>1, "Economics, Econometrics and Finance"=>3}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>13}, "Neuroscience"=>{"Neuroscience"=>1}, "Social Sciences"=>{"Social Sciences"=>1}, "Psychology"=>{"Psychology"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>3}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "reader_count_by_country"=>{"Netherlands"=>1}, "group_count"=>1}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1807687"], "description"=>"<p>List of studies used in meta-analysis, country of analysis, date of conducted studies, age at diagnosis, mean age patients, number of patients in the study, percentage of males in study, years of follow-up, mortality rates and measurement of risk of mortality.</p>", "links"=>[], "tags"=>["blood pressure control", "General Population", "Type 1 diabetes", "mortality", "effects model", "time.MethodsSystematic review", "type 1 diabetes patients", "Exploring Temporal Changes", "88 subpopulations", "RR estimates", "blood glucose control", "RR estimate", "Relative Mortality AimsType 1 diabetes", "statin therapy", "ci", "Relative risk", "1990. Emphasis", "summary RR"], "article_id"=>1252397, "categories"=>["Biological Sciences"], "users"=>["Tom W. C. Lung", "Alison J. Hayes", "William H. Herman", "Lei Si", "Andrew J. Palmer", "Philip M. Clarke"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113635.t001", "stats"=>{"downloads"=>7, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_List_of_studies_used_in_meta_analysis_country_of_analysis_date_of_conducted_studies_age_at_diagnosis_mean_age_patients_number_of_patients_in_the_study_percentage_of_males_in_study_years_of_follow_up_mortality_rates_and_measurement_of_risk_of_mortality_/1252397", "title"=>"List of studies used in meta-analysis, country of analysis, date of conducted studies, age at diagnosis, mean age patients, number of patients in the study, percentage of males in study, years of follow-up, mortality rates and measurement of risk of mortality.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-26 02:42:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/1807686"], "description"=>"<p>Horizontal bars and circles widths denote 95% CIs, and box sizes indicate relative weight in the analysis.</p>", "links"=>[], "tags"=>["blood pressure control", "General Population", "Type 1 diabetes", "mortality", "effects model", "time.MethodsSystematic review", "type 1 diabetes patients", "Exploring Temporal Changes", "88 subpopulations", "RR estimates", "blood glucose control", "RR estimate", "Relative Mortality AimsType 1 diabetes", "statin therapy", "ci", "Relative risk", "1990. Emphasis", "summary RR"], "article_id"=>1252396, "categories"=>["Biological Sciences"], "users"=>["Tom W. C. Lung", "Alison J. Hayes", "William H. Herman", "Lei Si", "Andrew J. Palmer", "Philip M. Clarke"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113635.g002", "stats"=>{"downloads"=>2, "page_views"=>30, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Random_effects_meta_analysis_by_median_study_date_lt_8202_8202_1970_1971_8211_1980_1981_8211_1990_gt_1990_/1252396", "title"=>"Random effects meta-analysis by median study date (< = 1970, 1971–1980, 1981–1990, >1990).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-11-26 02:42:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/1807631"], "description"=>"<p>Flow chart of study selection process.</p>", "links"=>[], "tags"=>["blood pressure control", "General Population", "Type 1 diabetes", "mortality", "effects model", "time.MethodsSystematic review", "type 1 diabetes patients", "Exploring Temporal Changes", "88 subpopulations", "RR estimates", "blood glucose control", "RR estimate", "Relative Mortality AimsType 1 diabetes", "statin therapy", "ci", "Relative risk", "1990. Emphasis", "summary RR"], "article_id"=>1252360, "categories"=>["Biological Sciences"], "users"=>["Tom W. C. Lung", "Alison J. Hayes", "William H. Herman", "Lei Si", "Andrew J. Palmer", "Philip M. Clarke"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113635.g001", "stats"=>{"downloads"=>0, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_chart_of_study_selection_process_/1252360", "title"=>"Flow chart of study selection process.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-11-26 02:42:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/1807691"], "description"=>"<p>*Median date of study standardized by deducting the median date of studies of 1982.</p><p>**66 observations conducted in Europe.</p><p>***Number of patients in study standardized by deducting the mean number of patients of 1163.</p><p>Meta-regression results, determining the factors that account for the heterogeneity between different studies’ relative risk of mortality estimates.</p>", "links"=>[], "tags"=>["blood pressure control", "General Population", "Type 1 diabetes", "mortality", "effects model", "time.MethodsSystematic review", "type 1 diabetes patients", "Exploring Temporal Changes", "88 subpopulations", "RR estimates", "blood glucose control", "RR estimate", "Relative Mortality AimsType 1 diabetes", "statin therapy", "ci", "Relative risk", "1990. Emphasis", "summary RR"], "article_id"=>1252401, "categories"=>["Biological Sciences"], "users"=>["Tom W. C. Lung", "Alison J. Hayes", "William H. Herman", "Lei Si", "Andrew J. Palmer", "Philip M. Clarke"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113635.t003", "stats"=>{"downloads"=>2, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_regression_results_determining_the_factors_that_account_for_the_heterogeneity_between_different_studies_8217_relative_risk_of_mortality_estimates_/1252401", "title"=>"Meta-regression results, determining the factors that account for the heterogeneity between different studies’ relative risk of mortality estimates.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-26 02:42:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/1807690"], "description"=>"<p>Meta-analysis results by different categories, showing the number observations used, the pooled estimate and 95% confidence intervals and I<sup>2</sup> estimate for heterogeneity.</p>", "links"=>[], "tags"=>["blood pressure control", "General Population", "Type 1 diabetes", "mortality", "effects model", "time.MethodsSystematic review", "type 1 diabetes patients", "Exploring Temporal Changes", "88 subpopulations", "RR estimates", "blood glucose control", "RR estimate", "Relative Mortality AimsType 1 diabetes", "statin therapy", "ci", "Relative risk", "1990. Emphasis", "summary RR"], "article_id"=>1252400, "categories"=>["Biological Sciences"], "users"=>["Tom W. C. Lung", "Alison J. Hayes", "William H. Herman", "Lei Si", "Andrew J. Palmer", "Philip M. Clarke"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113635.t002", "stats"=>{"downloads"=>7, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_results_by_different_categories_showing_the_number_observations_used_the_pooled_estimate_and_95_confidence_intervals_and_I_2_estimate_for_heterogeneity_/1252400", "title"=>"Meta-analysis results by different categories, showing the number observations used, the pooled estimate and 95% confidence intervals and I<sup>2</sup> estimate for heterogeneity.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-26 02:42:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/1807699"], "description"=>"<div><p>Aims</p><p>Type 1 diabetes has been associated with an elevated relative risk (RR) of mortality compared to the general population. To review published studies on the RR of mortality of Type 1 diabetes patients compared to the general population, we conducted a meta-analysis and examined the temporal changes in the RR of mortality over time.</p><p>Methods</p><p>Systematic review of studies reporting RR of mortality for Type 1 diabetes compared to the general population. We conducted meta-analyses using a DerSimonian and Laird random effects model to obtain the average effect and the distribution of RR estimates. Sub-group meta-analyses and multivariate meta-regression analysis was performed to examine heterogeneity. Summary RR with 95% CIs was calculated using a random-effects model.</p><p>Results</p><p>26 studies with a total of 88 subpopulations were included in the meta-analysis and overall RR of mortality was 3.82 (95% CI 3.41, 3.4.29) compared to the general population. Observations using data prior to 1971 had a much larger estimated RR (5.80 (95% CI 4.20, 8.01)) when compared to: data between; 1971 and 1980 (5.06 (95% CI 3.44, 7.45)); 1981–90 (3.59 (95% CI 3.15, 4.09)); and those after 1990 (3.11 (95% CI 2.47, 3.91)); suggesting mortality of Type 1 diabetes patients when compared to the general population have been improving over time. Similarly, females (4.54 (95% CI 3.79–5.45)) had a larger RR estimate when compared to males (3.25 (95% CI 2.82–3.73) and the meta-regression found evidence for temporal trends and sex (p<0.01) accounting for heterogeneity between studies.</p><p>Conclusions</p><p>Type 1 diabetes patients’ mortality has declined at a faster rate than the general population. However, the largest relative improvements have occurred prior to 1990. Emphasis on intensive blood glucose control alongside blood pressure control and statin therapy may translate into further reductions in mortality in coming years.</p></div>", "links"=>[], "tags"=>["blood pressure control", "General Population", "Type 1 diabetes", "mortality", "effects model", "time.MethodsSystematic review", "type 1 diabetes patients", "Exploring Temporal Changes", "88 subpopulations", "RR estimates", "blood glucose control", "RR estimate", "Relative Mortality AimsType 1 diabetes", "statin therapy", "ci", "Relative risk", "1990. Emphasis", "summary RR"], "article_id"=>1252406, "categories"=>["Biological Sciences"], "users"=>["Tom W. C. Lung", "Alison J. Hayes", "William H. Herman", "Lei Si", "Andrew J. Palmer", "Philip M. Clarke"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113635", "stats"=>{"downloads"=>2, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_A_Meta_Analysis_of_the_Relative_Risk_of_Mortality_for_Type_1_Diabetes_Patients_Compared_to_the_General_Population_Exploring_Temporal_Changes_in_Relative_Mortality_/1252406", "title"=>"A Meta-Analysis of the Relative Risk of Mortality for Type 1 Diabetes Patients Compared to the General Population: Exploring Temporal Changes in Relative Mortality", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-26 02:42:14"}

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