{"doi":"10.2337/figshare.13549142","title":"Quantifying Variation in Treatment Utilization for Type 2 Diabetes Across Five Major University of California Health Systems","abstract":"<jats:p>&lt;b&gt;Objective:&lt;/b&gt; Using the newly created University of\nCalifornia Health Data Warehouse (UCHDW), we present the first study to analyze\nantihyperglycemic treatment utilization across the five large University of\nCalifornia (UC) academic health systems (Davis, Irvine, Los Angeles, San Diego,\nand San Francisco).\n\n&lt;p&gt;&lt;b&gt;Research\nDesign:&lt;/b&gt; Retrospective\nanalysis using deidentified Electronic Health Records (EHRs; 2014-2019)\nincluding 97,231 type 2 diabetes patients from 1,003 UC-affiliated clinical\nsettings.  Significant differences between\nhealth systems and individual providers were identified using binomial\nprobabilities with cohort matching.&lt;/p&gt;\n\n&lt;p&gt;&lt;b&gt;Results&lt;/b&gt;: Our analysis reveals statistically\ndifferent treatment utilization patterns not only between health systems but\nalso among individual providers within health systems.  We identified 21 differences among health\nsystems, and 29 differences among individual providers within these health\nsystems, with respect to treatment intensifications within existing guidelines on\ntop of either metformin monotherapy or dual therapy with metformin and a sulfonylurea.\nNext, we identified variation for medications within the same class (e.g., glipizide\nvs. glyburide among sulfonylureas), with 33 differences among health systems\nand 86 among individual providers.  Finally,\nwe identified two health systems and 55 individual providers that more\nfrequently utilized medications with known cardioprotective benefits for patients\nwith high cardiovascular disease risk, but also one health system and 8\nproviders who prescribed such medications less frequently for these patients.&lt;/p&gt;\n\n&lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Our study utilized cohort matching\ntechniques to highlight real-world variation in care between health systems and\nindividual providers.  This demonstrates\nthe power of EHRs to quantify differences in treatment utilization, a necessary\nstep towards standardizing precision care for large populations.&lt;/p&gt;</jats:p>","journal":null,"year":2021,"id":3933,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.1593,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-02-02","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":39806,"name":"Valy Fontil","orcid":null,"position":1,"is_corresponding":false},{"id":29204,"name":"Suneil K. Koliwad","orcid":"0000-0002-7367-1054","position":2,"is_corresponding":false},{"id":32097,"name":"Ayan Patel","orcid":null,"position":3,"is_corresponding":false},{"id":51,"name":"Atul Janardhan Butte","orcid":"0000-0002-7433-2740","position":4,"is_corresponding":false},{"id":39807,"name":"Thomas Peterson","orcid":"0000-0002-9933-7556","position":5,"is_corresponding":false},{"id":32120,"name":"Ayan R. Patel","orcid":"0000-0003-1984-1400","position":6,"is_corresponding":false},{"id":16210,"name":"Thomas A. Peterson","orcid":"0000-0002-2562-6574","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-03-01T18:20:47.508186Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}