Diagnosis-and-Treatment Domain Scores
cardiometabolic diseases, DM/HTN
WEST
At baseline, we found wide variation in DxTx scores among participants caring for patients with cardiometabolic diseases. Across all patient cases, DxTx ranged from 0 to 75%, averaging 21.7%
Diagnosis-Treatment Scores by CPV VariantWe then compared control to the first intervention in a pre-post analysis. The formal difference-in-difference estimations using a fixed effects model showed a + 10.4% improvement in recognizing and treating NA and a + 10.8% improvement for identifying and treating DDI (p < 0.01 for both). There was no round over round improvement in the DxTx score for the AND patient cases.After controlling for gender, internal medicine specialty, age, region, practice locale and type, the fixed-effects model showed practicing in the West (+ 4.3%, 95% C.I. +2.2% to + 6.4%) and in non-urban environments (+ 2.1%, 95% C.I. +0.3% to + 3.9%) were correlated with higher DxTx scores. Comparing intervention to control, we found intervention 1 providers performed significantly better than controls across all patient cases (+ 4.5%, 95% C.I. +0.6% to + 8.3%). By case variant, the intervention group improved significantly for both the NA (+ 10.8%, 95% C.I. +3.4% to + 18.2%) and DDI cases (+ 11.0%, C.I. +4.2% to + 17.9%), but not for the AND cases (-7.6%, 95% C.I. -12.6% to -2.6%).By case type (Afib, HF, and DM/HTN), we found no significant improvement in DxTx score for the intervention group in the difference-in-difference fixed effects modeling (Afib: +2.9%; HF: +3.8%; DM/HTN: +6.7%; p > 0.05 for all). However, we did see improved identification of both NA and DDI across all case types (Afib, O.R. 39.7, 95% C.I. 5.1-309.4; HF, O.R. 19.2, 95% C.I. 1.6-230.7; DM/HTN, O.R. 99.0, 95% C.I. 8.8-1179.5).