Population segmentation of type 2 diabetes mellitus patients and its clinical applications - a scoping review

BackgroundPopulation segmentation permits the division of a heterogeneous population into relatively homogenous subgroups. This scoping review aims to summarize the clinical applications of data driven and expert driven population segmentation among Type 2 diabetes mellitus (T2DM) patients.MethodsThe literature search was conducted in Medline (R), Embase (R), Scopus (R) and PsycInfo (R). Articles which utilized expert-based or data-driven population segmentation methodologies for evaluation of outcomes among T2DM patients were included. Population segmentation variables were grouped into five domains (socio-demographic, diabetes related, non-diabetes medical related, psychiatric / psychological and health system related variables). A framework for PopulAtion Segmentation Study design for T2DM patients (PASS-T2DM) was proposed.ResultsOf 155,124 articles screened, 148 articles were included. Expert driven population segmentation approach was most commonly used, of which judgemental splitting was the main strategy employed (n=111, 75.0%). Cluster based analyses (n=37, 25.0%) was the main data driven population segmentation strategies utilized. Socio-demographic (n=66, 44.6%), diabetes related (n=54, 36.5%) and non-diabetes medical related (n=18, 12.2%) were the most used domains. Specifically, patients' race, age, Hba1c related parameters and depression / anxiety related variables were most frequently used. Health grouping/profiling (n=71, 48%), assessment of diabetes related complications (n=57, 38.5%) and non-diabetes metabolic derangements (n=42, 28.4%) were the most frequent population segmentation objectives of the studies.ConclusionsPopulation segmentation has a wide range of clinical applications for evaluating clinical outcomes among T2DM patients. More studies are required to identify the optimal set of population segmentation framework for T2DM patients.

Automated summary

Population segmentation allows for the division of heterogeneous populations into relatively homogeneous subgroups. This scoping review highlights the clinical applications of both data-driven and expert-driven segmentation strategies in Type 2 diabetes mellitus (T2DM) patients.