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From Hong Kong Diabetes Register to JADE Program to RAMP-DM for Data-Driven Actions

Chan JCN, Lim LL, Luk AOY, Ozaki R, Kong APS, Ma RCW, et al.

Diabetes Care, 2019 11;42(11):2022-2031.
PMID: 31530658 DOI: 10.2337/dci19-0003

In 1995, the Hong Kong Diabetes Register (HKDR) was established by a doctor-nurse team at a university-affiliated, publicly funded, hospital-based diabetes center using a structured protocol for gathering data to stratify risk, triage care, empower patients, and individualize treatment. This research-driven quality improvement program has motivated the introduction of a territory-wide diabetes risk assessment and management program provided by 18 hospital-based diabetes centers since 2000. By linking the data-rich HKDR to the territory-wide electronic medical record, risk equations were developed and validated to predict clinical outcomes. In 2007, the HKDR protocol was digitalized to establish the web-based Joint Asia Diabetes Evaluation (JADE) Program complete with risk levels and algorithms for issuance of personalized reports to reduce clinical inertia and empower self-management. Through this technologically assisted, integrated diabetes care program, we have generated big data to track secular trends, identify unmet needs, and verify interventions in a naturalistic environment. In 2009, the JADE Program was adapted to form the Risk Assessment and Management Program for Diabetes Mellitus (RAMP-DM) in the publicly funded primary care clinics, which reduced all major events by 30-60% in patients without complications. Meanwhile, a JADE-assisted assessment and empowerment program provided by a university-affiliated, self-funded, nurse-coordinated diabetes center, aimed at complementing medical care in the community, also reduced all major events by 30-50% in patients with different risk levels. By combining universal health coverage, public-private partnerships, and data-driven integrated care, the Hong Kong experience provides a possible solution than can be adapted elsewhere to make quality diabetes care accessible, affordable, and sustainable.

Matched MeSH terms: Risk Assessment/standards*
Gaining competitive advantage in personal dosimetry services through ISO 9001 certification

Noriah MA

Radiat Prot Dosimetry, 2007;125(1-4):101-4.
PMID: 17145724

This paper discusses the advantage of certification process in the quality assurance of individual dose monitoring in Malaysia. The demand by customers and the regulatory authority for a higher degree of quality service requires a switch in emphasis from a technically focused quality assurance program to a comprehensive quality management for service provision. Achieving the ISO 9001:2000 certification by an accredited third party demonstrates acceptable recognition and documents the fact that the methods used are capable of generating results that satisfy the performance criteria of the certification program. It also offers a proof of the commitment to quality and, as a benchmark, allows measurement of the progress for continual improvement of service performance.

Matched MeSH terms: Risk Assessment/standards*
Fulltext Quantifying the risk of Zika virus spread in Asia during the 2015-16 epidemic in Latin America and the Caribbean: A modeling study

Luo XS, Imai N, Dorigatti I

Travel Med Infect Dis, 2020 01 26;33:101562.
PMID: 31996323 DOI: 10.1016/j.tmaid.2020.101562

BACKGROUND: No large-scale Zika epidemic has been observed to date in Southeast Asia following the 2015-16 Latin American and the Caribbean epidemic. One hypothesis is Southeast Asian populations' partial immunity to Zika.
METHOD: We estimated the two conditions for a Zika outbreak emergence in Southeast Asia: (i) the risk of Zika introduction from Latin America and the Caribbean and, (ii) the risk of autochthonous transmission under varying assumptions on population immunity. We also validated the model used to estimate the risk of introduction by comparing the estimated number of Zika seeds introduced into the United States with case counts reported by the Centers for Disease Control and Prevention (CDC).
RESULTS: There was good agreement between our estimates and case counts reported by the CDC. We thus applied the model to Southeast Asia and estimated that, on average, 1-10 seeds were introduced into Indonesia, Malaysia, the Philippines, Singapore, Thailand and Vietnam. We also found increasing population immunity levels from 0 to 90% reduced probability of autochthonous transmission by 40% and increasing individual variation in transmission further reduced the outbreak probability.
CONCLUSIONS: Population immunity, combined with heterogeneity in transmission, can explain why no large-scale outbreak was observed in Southeast Asia during the 2015-16 epidemic.

Matched MeSH terms: Risk Assessment/standards

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