89-LB: Low Level of Agreement in Evaluation of Continuous Glucose Monitoring Profiles

Abstract

Nearly 20 years after the introduction of Continuous Glucose Monitoring (CGM) it is clear that CGM reports can effectively guide clinical decision making but the large amount of information contained in the CGM profile may also complicate the evaluation of the profiles. We hypothesized that there would be a relatively low level of agreement in evaluations of CGM-profiles performed by a diverse group of HCPs and patients, with higher level of agreement between diabetes experts. We investigated the interobserver variation in the two groups when asked to subjectively prioritize 9 Ambulatory Glucose Profiles from ‘best’ to ‘worst’ through an internet-based portal (www.glucoseprofile.com). A total of 88 responses were collected. The groups were defined as non-experts (N = 73) and self-evaluated experts (>10 years of experience and > 1 CGM evaluation per week) (N = 15). The interobserver variation between the groups were calculated using Interclass Correlation Coefficients (ICC) showing moderate agreement among the non-experts group (ICC = 0.60) and a good degree of agreement among the diabetes experts (ICC=0.75) [Figure]. Despite standardized CGM metrics and reports there is still a relatively low level of agreement in interpretation and ranking of CGM-profiles even among diabetes experts. This may allow for undesirable variation in diabetes management. More tools are needed to optimize the use of CGM for clinical decision making. Disclosure E. Hachmann-Nielsen: Employee; Self; Novo Nordisk A/S. K. Kvist: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. R.M. Bergenstal: Research Support; Self; Abbott, Boehringer Ingelheim Pharmaceuticals, Inc., Dexcom, Inc., Glooko, Inc., Hygieia, JDRF, Johnson & Johnson Medical Devices Companies, Lilly Diabetes, Medtronic MiniMed, Inc., Merck & Co., Inc., National Institute of Diabetes and Digestive and Kidney Diseases, Novo Nordisk Inc., Roche Diabetes Care, Sanofi. Other Relationship; Self; Abbott, Helmsley Charitable Trust, Hygieia, Lilly Diabetes, Novo Nordisk Inc., Onduo LLC, Sanofi, UnitedHealth Group Inc. Funding Novo Nordisk