{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T17:39:56Z","timestamp":1770917996147,"version":"3.50.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T00:00:00Z","timestamp":1696809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000062","name":"NIDDK","doi-asserted-by":"publisher","award":["U18DP006512"],"award-info":[{"award-number":["U18DP006512"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"NIDDK","doi-asserted-by":"publisher","award":["NIDDK R01DK133465"],"award-info":[{"award-number":["NIDDK R01DK133465"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Having sufficient population coverage from the electronic health records (EHRs)-connected health system is essential for building a comprehensive EHR-based diabetes surveillance system. This study aimed to establish an EHR-based type 1 diabetes (T1D) surveillance system for children and adolescents across racial and ethnic groups by identifying the minimum population coverage from EHR-connected health systems to accurately estimate T1D prevalence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>We conducted a retrospective, cross-sectional analysis involving children and adolescents &amp;lt;20\u00a0years old identified from the OneFlorida+ Clinical Research Network (2018-2020). T1D cases were identified using a previously validated computable phenotyping algorithm. The T1D prevalence for each ZIP Code Tabulation Area (ZCTA, 5 digits), defined as the number of T1D cases divided by the total number of residents in the corresponding ZCTA, was calculated. Population coverage for each ZCTA was measured using observed health system penetration rates (HSPR), which was calculated as the ratio of residents in the corresponding ZTCA and captured by OneFlorida+ to the overall population in the same ZCTA reported by the Census. We used a recursive partitioning algorithm to identify the minimum required observed HSPR to estimate T1D prevalence and compare our estimate with the reported T1D prevalence from the SEARCH study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Observed HSPRs of 55%, 55%, and 60% were identified as the minimum thresholds for the non-Hispanic White, non-Hispanic Black, and Hispanic populations. The estimated T1D prevalence for non-Hispanic White and non-Hispanic Black were 2.87 and 2.29 per 1000 youth, which are comparable to the reference study\u2019s estimation. The estimated prevalence of T1D for Hispanics (2.76 per 1000 youth) was higher than the reference study\u2019s estimation (1.48-1.64 per 1000 youth). The standardized T1D prevalence in the overall Florida population was 2.81 per 1000 youth in 2019.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our study provides a method to estimate T1D prevalence in children and adolescents using EHRs and reports the estimated HSPRs and prevalence of T1D for different race and ethnicity groups to facilitate EHR-based diabetes surveillance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocad194","type":"journal-article","created":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T21:00:32Z","timestamp":1696885232000},"page":"165-173","source":"Crossref","is-referenced-by-count":2,"title":["The role of health system penetration rate in estimating the prevalence of type 1 diabetes in children and adolescents using electronic health records"],"prefix":"10.1093","volume":"31","author":[{"given":"Piaopiao","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida , Gainesville, FL, United States"},{"name":"Hubert Department of Global Health, Rollins School of Public Health, Emory University , Atlanta, GA, United States"}]},{"given":"Tianchen","family":"Lyu","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida , Gainesville, FL, United States"}]},{"given":"Khalid","family":"Alkhuzam","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida , Gainesville, FL, United States"}]},{"given":"Eliot","family":"Spector","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida , Gainesville, FL, United States"}]},{"given":"William T","family":"Donahoo","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes & Metabolism, College of Medicine, University of Florida , Gainesville, FL, United States"}]},{"given":"Sarah","family":"Bost","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida , Gainesville, FL, United States"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6780-6135","authenticated-orcid":false,"given":"Yonghui","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida , Gainesville, FL, United States"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9881-1017","authenticated-orcid":false,"given":"William R","family":"Hogan","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida , Gainesville, FL, United States"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9021-5595","authenticated-orcid":false,"given":"Mattia","family":"Prosperi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health and Health Professions, University of Florida , Gainesville, FL, United States"}]},{"given":"Desmond A","family":"Schatz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, University of Florida , Gainesville, FL, United States"}]},{"given":"Mark A","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Diabetes Institute, University of Florida , Gainesville, FL, United States"}]},{"given":"Michael J","family":"Haller","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, University of Florida , Gainesville, FL, United States"}]},{"given":"Elizabeth A","family":"Shenkman","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida , Gainesville, FL, United States"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0587-4105","authenticated-orcid":false,"given":"Yi","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida , Gainesville, FL, United States"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2238-5429","authenticated-orcid":false,"given":"Jiang","family":"Bian","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida , Gainesville, FL, United States"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4088-546X","authenticated-orcid":false,"given":"Hui","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida , Gainesville, FL, United States"},{"name":"Hubert Department of Global Health, Rollins School of Public Health, Emory University , Atlanta, GA, United States"},{"name":"Center for Drug Evaluation and Safety, University of Florida , Gainesville, FL, United States"},{"name":"Department of Family and Preventive Medicine, School of Medicine, Emory University , Atlanta, GA, United States"}]}],"member":"286","published-online":{"date-parts":[[2023,10,9]]},"reference":[{"issue":"7","key":"2023122220292812800_ocad194-B1","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1001\/jama.303.7.682","article-title":"Chronic diseases of children","volume":"303","author":"Torpy","year":"2010","journal-title":"JAMA"},{"issue":"8","key":"2023122220292812800_ocad194-B2","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1001\/jama.2021.11165","article-title":"Trends in prevalence of type 1 and type 2 diabetes in children and adolescents in the US, 2001-2017","volume":"326","author":"Lawrence","year":"2021","journal-title":"JAMA"},{"issue":"6","key":"2023122220292812800_ocad194-B3","doi-asserted-by":"crossref","first-page":"161","DOI":"10.15585\/mmwr.mm6906a3","article-title":"Trends in incidence of type 1 and type 2 diabetes among youths \u2013 selected counties and Indian reservations, United States, 2002\u20132015","volume":"69","author":"Divers","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"10035","key":"2023122220292812800_ocad194-B4","doi-asserted-by":"crossref","first-page":"2340","DOI":"10.1016\/S0140-6736(16)30507-4","article-title":"Environmental risk factors for type 1 diabetes","volume":"387","author":"Rewers","year":"2016","journal-title":"Lancet"},{"issue":"8","key":"2023122220292812800_ocad194-B5","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/pedi.12152","article-title":"Use of administrative and electronic health record data for development of automated algorithms for childhood diabetes case ascertainment and type classification: the SEARCH for Diabetes in Youth Study","volume":"15","author":"Zhong","year":"2014","journal-title":"Pediatr Diabetes"},{"issue":"5","key":"2023122220292812800_ocad194-B6","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1001\/archpedi.160.5.523","article-title":"Prevalence of diabetes and impaired fasting glucose levels among US adolescents: National Health and Nutrition Examination Survey, 1999-2002","volume":"160","author":"Duncan","year":"2006","journal-title":"Arch Pediatr Adolesc Med"},{"key":"2023122220292812800_ocad194-B7","author":"SEARCH for Diabetes in Youth"},{"issue":"15","key":"2023122220292812800_ocad194-B8","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1056\/NEJMoa1610187","article-title":"Incidence trends of type 1 and type 2 diabetes among youths, 2002\u20132012","volume":"376","author":"Mayer-Davis","year":"2017","journal-title":"N Engl J Med"},{"issue":"7","key":"2023122220292812800_ocad194-B9","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1111\/pedi.12885","article-title":"Increasing burden of type 2 diabetes in Navajo youth: the SEARCH for diabetes in youth study","volume":"20","author":"Powell","year":"2019","journal-title":"Pediatr Diabetes"},{"issue":"8","key":"2023122220292812800_ocad194-B10","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1111\/dme.13983","article-title":"Socio-economic, demographic, and clinical correlates of poor glycaemic control within insulin regimens among children with type 1 diabetes: the SEARCH for Diabetes in Youth Study","volume":"36","author":"Snyder","year":"2019","journal-title":"Diabet Med"},{"issue":"6","key":"2023122220292812800_ocad194-B11","first-page":"693","article-title":"Trends in prevalence of cardiovascular risk factors from 2002 to 2012 among youth early in the course of type 1 and type 2 diabetes. The SEARCH for Diabetes in Youth Study","volume":"20","author":"Kim","year":"2019","journal-title":"Pediatr Diabetes"},{"key":"2023122220292812800_ocad194-B12","author":"SEARCH for Diabetes in Youth"},{"issue":"1 Pt 2","key":"2023122220292812800_ocad194-B13","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1111\/1475-6773.12135","article-title":"Clinical benefits of electronic health record use: national findings","volume":"49","author":"King","year":"2014","journal-title":"Health Serv Res"},{"issue":"1","key":"2023122220292812800_ocad194-B14","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1186\/1471-2458-13-251","article-title":"Comparison of the information provided by electronic health records data and a population health survey to estimate prevalence of selected health conditions and multimorbidity","volume":"13","author":"Viol\u00e1n","year":"2013","journal-title":"BMC Public Health"},{"key":"2023122220292812800_ocad194-B15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2147\/CLEP.S181242","article-title":"Measuring prevalence and incidence of chronic conditions in claims and electronic health record databases","volume":"11","author":"Rassen","year":"2018","journal-title":"Clin Epidemiol"},{"issue":"3","key":"2023122220292812800_ocad194-B16","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1097\/ACM.0000000000002029","article-title":"OneFlorida Clinical Research Consortium: linking a clinical and translational science institute with a community-based distributive medical education model","volume":"93","author":"Shenkman","year":"2018","journal-title":"Acad Med"},{"issue":"4","key":"2023122220292812800_ocad194-B17","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1136\/amiajnl-2014-002864","article-title":"PCORnet: turning a dream into reality","volume":"21","author":"Collins","year":"2014","journal-title":"J Am Med Inform Assoc"},{"key":"2023122220292812800_ocad194-B18","doi-asserted-by":"crossref","first-page":"1262-P","DOI":"10.2337\/db22-1262-P","article-title":"1262-P: developing a computable phenotype algorithm for identification of children and adolescents with diabetes using electronic health records","volume":"71(Suppl 1)","author":"Li","year":"2022","journal-title":"Diabetes"},{"key":"2023122220292812800_ocad194-B19","author":"United States Census Bureau"},{"key":"2023122220292812800_ocad194-B20","doi-asserted-by":"crossref","first-page":"1265-P","DOI":"10.2337\/db22-1265-P","article-title":"1265-P: the role of health system penetration rate in estimating prevalence of type 1 diabetes (T1D) in children and adolescents using electronic health records (EHR)","volume":"71(Suppl 1)","author":"Li","year":"2022","journal-title":"Diabetes"},{"issue":"1","key":"2023122220292812800_ocad194-B21","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1097\/00005650-200201000-00007","article-title":"Disparities in health care by race, ethnicity, and language among the insured: findings from a national sample","volume":"40","author":"Fiscella","year":"2002","journal-title":"Med Care"},{"key":"2023122220292812800_ocad194-B22","doi-asserted-by":"crossref","first-page":"I64","DOI":"10.1097\/01.mlr.0000208195.83749.c3","article-title":"Explaining racial and ethnic disparities in health care","volume":"44","author":"Kirby","year":"2006","journal-title":"Med Care"},{"key":"2023122220292812800_ocad194-B23","author":"United States Census Bureau"},{"key":"2023122220292812800_ocad194-B24","author":"Pew Research Center"},{"issue":"7","key":"2023122220292812800_ocad194-B25","doi-asserted-by":"crossref","first-page":"618","DOI":"10.2337\/diacare.14.7.618","article-title":"Origins of U.S. Hispanics. Implications for diabetes","volume":"14","author":"Hanis","year":"1991","journal-title":"Diabetes Care"},{"issue":"4","key":"2023122220292812800_ocad194-B26","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1093\/jn\/137.4.860","article-title":"The role of acculturation in nutrition, lifestyle, and incidence of type 2 diabetes among Latinos","volume":"137","author":"P\u00e9rez-Escamilla","year":"2007","journal-title":"J Nutr"},{"issue":"1","key":"2023122220292812800_ocad194-B27","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1111\/j.1748-0361.2006.00009.x","article-title":"Rural residence and Hispanic ethnicity: doubly disadvantaged for diabetes?","volume":"22","author":"Koopman","year":"2006","journal-title":"J Rural Health"},{"issue":"11","key":"2023122220292812800_ocad194-B28","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1111\/j.1532-5415.1998.tb06005.x","article-title":"The prevalence of diabetes and associated coronary risk factors in urban and rural older Mexican populations","volume":"46","author":"Lerman","year":"1998","journal-title":"J Am Geriatr Soc"},{"issue":"8","key":"2023122220292812800_ocad194-B29","doi-asserted-by":"crossref","first-page":"2673","DOI":"10.1007\/s40519-021-01138-z","article-title":"Diabetes prevalence among diverse Hispanic populations: considering nativity, ethnic discrimination, acculturation, and BMI","volume":"26","author":"Kamody","year":"2021","journal-title":"Eat Weight Disord"},{"issue":"8","key":"2023122220292812800_ocad194-B30","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s11606-010-1335-8","article-title":"Hypertension and diabetes prevalence among U.S. Hispanics by country of origin: the National Health Interview Survey 2000-2005","volume":"25","author":"Pabon-Nau","year":"2010","journal-title":"J Gen Intern Med"},{"issue":"1","key":"2023122220292812800_ocad194-B31","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1186\/s12889-020-09311-2","article-title":"Investigation of geographic disparities of pre-diabetes and diabetes in Florida","volume":"20","author":"Lord","year":"2020","journal-title":"BMC Public Health"},{"issue":"1","key":"2023122220292812800_ocad194-B32","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1748-0361.2009.00259.x","article-title":"Diabetes burden and access to preventive care in the rural United States","volume":"26","author":"Krishna","year":"2010","journal-title":"J Rural Health"},{"issue":"2","key":"2023122220292812800_ocad194-B33","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1177\/0145721708316318","article-title":"Diabetes care and education in rural regions","volume":"34","author":"O\u2019Brien","year":"2008","journal-title":"Diabetes Educ"},{"key":"2023122220292812800_ocad194-B34","author":"Health Resources & Services Administration"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/31\/1\/165\/54761949\/ocad194.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/31\/1\/165\/54761949\/ocad194.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T20:30:05Z","timestamp":1703277005000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/31\/1\/165\/7301315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,9]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,10,9]]},"published-print":{"date-parts":[[2023,12,22]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocad194","relation":{},"ISSN":["1067-5027","1527-974X"],"issn-type":[{"value":"1067-5027","type":"print"},{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,1,1]]},"published":{"date-parts":[[2023,10,9]]}}}