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Iwata R, Mochizuki S, Hasegawa T, Ishii K, Matsumaru N, Tsukamoto K. Preventive Effects of Bioabsorbable Anti-Adhesion Barriers on Bowel Obstruction After Colectomy in Colon Cancer Patients: A Retrospective Cohort Study Using an Insurance Claims Database. Ther Innov Regul Sci 2024; 58:831-837. [PMID: 38710990 DOI: 10.1007/s43441-024-00660-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 05/01/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE Postoperative adhesions can be prevented by the use of bioabsorbable anti-adhesion barriers. Although the occurrence of postoperative bowel obstruction is an important concern for patients, at the time of approval of anti-adhesion barriers, its effectiveness in preventing postoperative bowel obstruction had not been evaluated. We aimed to retrospectively evaluate the incidence of bowel obstruction after colectomy in patients with colon cancer using an insurance claims database. METHODS This retrospective cohort study analyzed the data of colon cancer patients (between 2005 and 2017 from a national insurance claims database) who underwent colectomies to compare the proportion of individuals with postoperative bowel obstruction between the barrier and no barrier groups. RESULTS Of the 587 patients who met the inclusion criteria, 308 and 279 patients were identified as the barrier and no barrier groups, respectively. The incidence of postoperative bowel obstruction was significantly lower in the barrier group (log-rank test, P = 0.0483). The cumulative incidence of postoperative bowel obstruction 37 months after the initial colectomy was 6.1% and 10.9% in the barrier and no barrier groups, respectively. Moreover, consistent results were obtained in the matched cohort. CONCLUSION In colectomies for patients with colon cancer, the use of anti-adhesion barriers could significantly reduce the incidence of postoperative bowel obstruction. Evaluations using insurance claims databases could provide important information on outcomes following implementation of medical devices.
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Affiliation(s)
- Risa Iwata
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan.
- Medical Device Unit, Pharmaceuticals and Medical Devices Agency, Kasumigaseki 3-3-2, Chiyoda-ku, 100-0013, Tokyo, Japan.
| | - Shuichi Mochizuki
- Medical Device Unit, Pharmaceuticals and Medical Devices Agency, Kasumigaseki 3-3-2, Chiyoda-ku, 100-0013, Tokyo, Japan
| | - Tomoaki Hasegawa
- Division of Pharmacoepidemiology, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Kensuke Ishii
- Medical Device Unit, Pharmaceuticals and Medical Devices Agency, Kasumigaseki 3-3-2, Chiyoda-ku, 100-0013, Tokyo, Japan
| | - Naoki Matsumaru
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Katsura Tsukamoto
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
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Sekine A, Nakajima K. Agreement in All-in-One Dataset between Diagnosis and Prescribed Medication for Common Cardiometabolic Diseases in the NDB-K7Ps. EPIDEMIOLOGIA 2023; 4:370-381. [PMID: 37873883 PMCID: PMC10594522 DOI: 10.3390/epidemiologia4040034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/25/2023] Open
Abstract
The Japanese National Database (NDB), a useful data source for epidemiological studies, contains information on health checkups, disease diagnoses, and medications, which can be used when investigating common cardiometabolic diseases. However, before the initiation of an integrated analysis, we need to combine several pieces of information prepared separately into an all-in-one dataset (AIOD) and confirm the validation of the dataset for the study. In this study, we aimed to confirm the degree of agreement in data entries between diagnoses and prescribed medications and self-reported pharmacotherapy for common cardiometabolic diseases in newly assembled AIODs. The present study included 10,183,619 people who underwent health checkups from April 2018 to March 2019. Over 95% of patients prescribed antihypertensive and antidiabetic medications were diagnosed with each disease. For dyslipidemia, over 95% of patients prescribed medications were diagnosed with at least one of the following: dyslipidemia, hypercholesterolemia, or hyperlipidemia. Similarly, over 95% of patients prescribed medications for hyperuricemia were diagnosed with either hyperuricemia or gout. Additionally, over 90% of patients with self-reported medications for hypertension, diabetes, and dyslipidemia were diagnosed with each disease, although the proportions differed among age groups. Our study demonstrated high levels of agreement between diagnoses and prescribed medications for common cardiometabolic diseases and self-reported pharmacotherapy in our AIOD.
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Affiliation(s)
- Airi Sekine
- Department of Food and Nutrition, Faculty of Human Sciences and Design, Japan Women’s University, Tokyo 112-8681, Japan;
| | - Kei Nakajima
- Department of Food and Nutrition, Faculty of Human Sciences and Design, Japan Women’s University, Tokyo 112-8681, Japan;
- Department of Endocrinology and Diabetes, Saitama Medical Center, Saitama Medical University, Kawagoe 350-8550, Japan
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Suto M, Sugiyama T, Imai K, Furuno T, Hosozawa M, Ichinose Y, Ihana-Sugiyama N, Kodama T, Koizumi R, Shimizu-Motohashi Y, Murata S, Nakamura Y, Niino M, Sato M, Taguchi R, Takegami M, Tanaka M, Tsutsumimoto K, Usuda K, Takehara K, Iso H. Studies of Health Insurance Claims Data in Japan: A Scoping Review. JMA J 2023; 6:233-245. [PMID: 37560376 PMCID: PMC10407298 DOI: 10.31662/jmaj.2022-0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/12/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Health insurance claims data are used in various research fields; however, an overview on how they are used in healthcare research is scarce in Japan. Therefore, we conducted a scoping review to systematically map the relevant studies using Japanese claims data. METHODS MEDLINE, EMBASE, and Ichushi-Web were searched up to April 2021 for studies using Japanese healthcare claims data. We abstracted the data on study characteristics and summarized target diseases and research themes by the types of claims database. Moreover, we described the results of studies that aimed to compare health insurance claims data with other data sources narratively. RESULTS A total of 1,493 studies were included. Overall, the most common disease classifications were "Diseases of the circulatory system" (18.8%, n = 281), "Endocrine, nutritional, and metabolic diseases" (11.5%, n = 171; mostly diabetes), and "Neoplasms" (10.9%, n = 162), and the most common research themes were "medical treatment status" (30.0%, n = 448), "intervention effect" (29.9%, n = 447), and "clinical epidemiology, course of diseases" (27.9%, n = 417). Frequent diseases and themes varied by type of claims databases. A total of 19 studies aimed to assess the validity of the claims-based definition, and 21 aimed to compare the results of claims data with other data sources. Most studies that assessed the validity of claims data compared to medical records were hospital-based, with a small number of institutions. CONCLUSIONS Claims data are used in various research areas and will increasingly provide important evidence for healthcare policy in Japan. It is important to use previous claims database studies and share information on methodology among researchers, including validation studies, while informing policymakers about the applicability of claims data for healthcare planning and management.
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Affiliation(s)
- Maiko Suto
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Takehiro Sugiyama
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kenjiro Imai
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takashi Furuno
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mariko Hosozawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuichi Ichinose
- Division of Health Services Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Noriko Ihana-Sugiyama
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomoko Kodama
- Department of Public Health Policy, National Institute of Public Health, Saitama, Japan
| | - Ryuji Koizumi
- AMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuko Shimizu-Motohashi
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Shunsuke Murata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yayoi Nakamura
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mariko Niino
- Division of Health Services Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Misuzu Sato
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Reina Taguchi
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
- Institute for Health Economics and Policy, Tokyo, Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Motoko Tanaka
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- Department of Health Care Policy and Management, Doctoral Program in Public Health, Degree Programs in Comprehensive Human Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Kentaro Usuda
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kenji Takehara
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Hiroyasu Iso
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
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Yamana H, Konishi T, Yasunaga H. Validation studies of Japanese administrative health care data: A scoping review. Pharmacoepidemiol Drug Saf 2023; 32:705-717. [PMID: 37146098 DOI: 10.1002/pds.5636] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 04/04/2023] [Accepted: 04/28/2023] [Indexed: 05/07/2023]
Abstract
PURPOSE Large-scale administrative health care databases are increasingly being utilized for research. However, there has not been much literature that validated administrative data in Japan; a previous review identified six validation studies published between 2011 and 2017. We conducted a literature review of studies that assessed the validity of Japanese administrative health care data. METHODS We searched for studies published by March 2022 that compared individual-level administrative data with a reference standard from another data source, as well as studies that validated administrative data using other data within the same database. The eligible studies were also summarized based on characteristics which included data types, settings, reference standard used, numbers of patients, and conditions validated. RESULTS There were 36 eligible studies, including 29 that used external reference standard and seven that validated administrative data using other data within the same database. Chart review was the reference standard in 21 studies (range of the numbers of patients, 72-1674; 11 studies conducted in single institutions and nine studies in 2-5 institutions). Five studies used a disease registry as the reference standard. Diagnoses of cardiovascular diseases, cancer, and diabetes were frequently evaluated. CONCLUSIONS Validation studies are being conducted at an increasing rate in Japan, although most of them are small scale. Further large-scale comprehensive validation studies are necessary to effectively utilize the databases for research.
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Affiliation(s)
- Hayato Yamana
- Data Science Center, Jichi Medical University, Shimotsuke, Japan
- Department of Clinical Data Management and Research, Clinical Research Center, National Hospital Organization Headquarters, Meguro, Japan
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Bunkyo, Japan
| | - Takaaki Konishi
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Bunkyo, Japan
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Bunkyo, Japan
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Maeda T, Nishi T, Harada M, Tanno K, Nishiya N, Asayama K, Okuda N, Sugiyama D, Yatsuya H, Okayama A, Arima H. Influence of the COVID-19 pandemic on regular clinic visits and medication prescriptions among people with diabetes: Retrospective cohort analysis of health care claims. Medicine (Baltimore) 2022; 101:e29458. [PMID: 35866768 PMCID: PMC9302258 DOI: 10.1097/md.0000000000029458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The aim of this study was to investigate the effect of the COVID-19 pandemic on regular clinic visits among people with diabetes and to elucidate the factors related to visit patterns among these patients during the pandemic. This was a longitudinal study using anonymized insurance claims data from the Joint Health Insurance Society in Tokyo from October 2017 to September 2020. First, we identified patients with diabetes who were fully enrolled in the health plan from fiscal year 2017 until September 2020 and who were regularly receiving glucose-lowering medications (every 1-3 months) from October 2017 to September 2018. We divided follow-up into the pre-pandemic period (October 2018 to March 2020) and the pandemic period (April 2020 to September 2020). A multilevel logistic regression model was used to determine the risks of delayed clinic visits/medication prescriptions (i.e., >3 months after a previous visit/prescription) during the pandemic period. We identified 1118 study participants. The number of delayed clinic visits/medication prescriptions during the pre-pandemic and pandemic periods was 188/3354 (5.6%) and 125/1118 (11.2%), respectively. There was a significant increase in delayed clinic visits during the pandemic (adjusted odds ratio 3.68 (95% confidence interval 2.24 to 6.04, P < .001), even after controlling for confounding factors. We also found a significant interaction between sex and delayed visits; women had significantly fewer clinic visits during the COVID-19 pandemic than men. We clarified the relationship of the COVID-19 pandemic with delays in regular clinic visits and medication prescriptions among people with diabetes. The response to the COVID-19 pandemic differed between men and women.
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Affiliation(s)
- Toshiki Maeda
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- *Correspondence: Toshiki Maeda, Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan (e-mail: )
| | - Takumi Nishi
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Department of Research Planning and Information Management, Fukuoka Institute of Health and Environmental Sciences, Fukuoka, Japan
| | - Masataka Harada
- Department of Industrial Economics, Faculty of Economics, Fukuoka University, Fukuoka, Japan
| | - Kozo Tanno
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Iwate, Japan
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Morioka Iwate, Japan
| | - Naoyuki Nishiya
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Morioka Iwate, Japan
- Division of Integrated Information for Pharmaceutical Sciences, Department of Clinical Pharmacy, Iwate Medical University School of Pharmacy, Iwate, Japan
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
- KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Nagako Okuda
- Department of Health Science, Kyoto Prefectural University, Kyoto, Japan
| | - Daisuke Sugiyama
- Faculty of Nursing And Medical Care, Keio University, Tokyo, Japan
| | - Hiroshi Yatsuya
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Aichi, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Incidence of interventions for diabetic retinopathy and serious lower-limb complications and its related factors in patients with type 2 diabetes using a real-world large claims database. Diabetol Int 2022; 13:548-560. [PMID: 35693997 PMCID: PMC9174399 DOI: 10.1007/s13340-021-00566-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 12/20/2021] [Indexed: 01/16/2023]
Abstract
Aims To examine the incidence of interventions for diabetic retinopathy and serious limb complications and to elucidate the patient attributes related to the incidence of each intervention based on real-world claims data from Japan. Materials and methods A retrospective longitudinal study design involving a 9 year (2009-2018) claims database obtained from the JMDC Inc. Patients with type 2 diabetes aged 20-74 years taking antidiabetic medications were divided into two groups: "patients with newly initiated antidiabetic medication" (Group 1, n = 47,201) and "patients with continuing antidiabetic medication" (Group 2, n = 82,332). The incidence rate for each intervention was analyzed. We also divided Group 1 into the former and latter periods and investigated temporal changes. Results The incidences of the first retinopathy intervention (laser photocoagulation, vitrectomy, or intraocular injection), vitrectomy, and lower-limb amputations in Group 1 were 7.46, 2.37, and 0.31 /1000 person-years, respectively. Those in Group 2 were about 1.2-1.5 times higher. Older age, insulin use, and being dependents rather than insured persons were associated with a higher incidence in both groups after adjustment. While the incidence of the interventions for retinopathy hardly changed during the observation period, that of lower-limb amputations decreased by 40%, with less statistical significance (p = 0.11). Conclusions We showed the incidences of the first retinopathy interventions and lower-limb amputations and their secular trends in patients with diabetes, stratified by whether the antidiabetic medication was newly initiated or not. Older age, insulin use, and being dependents were risk factors of these interventions for diabetic complications. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-021-00566-7.
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Barrett CE, Park J, Kompaniyets L, Baggs J, Cheng YJ, Zhang P, Imperatore G, Pavkov ME. Intensive Care Unit Admission, Mechanical Ventilation, and Mortality Among Patients With Type 1 Diabetes Hospitalized for COVID-19 in the U.S. Diabetes Care 2021; 44:1788-1796. [PMID: 34158365 PMCID: PMC9109617 DOI: 10.2337/dc21-0604] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/16/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To assess whether risk of severe outcomes among patients with type 1 diabetes mellitus (T1DM) hospitalized for coronavirus disease 2019 (COVID-19) differs from that of patients without diabetes or with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS Using the Premier Healthcare Database Special COVID-19 Release records of patients discharged after COVID-19 hospitalization from U.S. hospitals from March to November 2020 (N = 269,674 after exclusion), we estimated risk differences (RD) and risk ratios (RR) of intensive care unit admission or invasive mechanical ventilation (ICU/MV) and of death among patients with T1DM compared with patients without diabetes or with T2DM. Logistic models were adjusted for age, sex, and race or ethnicity. Models adjusted for additional demographic and clinical characteristics were used to examine whether other factors account for the associations between T1DM and severe COVID-19 outcomes. RESULTS Compared with patients without diabetes, T1DM was associated with a 21% higher absolute risk of ICU/MV (RD 0.21, 95% CI 0.19-0.24; RR 1.49, 95% CI 1.43-1.56) and a 5% higher absolute risk of mortality (RD 0.05, 95% CI 0.03-0.07; RR 1.40, 95% CI 1.24-1.57), with adjustment for age, sex, and race or ethnicity. Compared with T2DM, T1DM was associated with a 9% higher absolute risk of ICU/MV (RD 0.09, 95% CI 0.07-0.12; RR 1.17, 95% CI 1.12-1.22), but no difference in mortality (RD 0.00, 95% CI -0.02 to 0.02; RR 1.00, 95% CI 0.89-1.13). After adjustment for diabetic ketoacidosis (DKA) occurring before or at COVID-19 diagnosis, patients with T1DM no longer had increased risk of ICU/MV (RD 0.01, 95% CI -0.01 to 0.03) and had lower mortality (RD -0.03, 95% CI -0.05 to -0.01) in comparisons with patients with T2DM. CONCLUSIONS Patients with T1DM hospitalized for COVID-19 are at higher risk for severe outcomes than those without diabetes. Higher risk of ICU/MV in patients with T1DM than in patients with T2DM was largely accounted for by the presence of DKA. These findings might further guide recommendations related to diabetes management and the prevention of COVID-19.
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Affiliation(s)
- Catherine E Barrett
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA .,COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Joohyun Park
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - James Baggs
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Yiling J Cheng
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Ping Zhang
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Giuseppina Imperatore
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Meda E Pavkov
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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