# Epidemiology and clinical outcomes of diabetic macular edema

> **NIH NIH K23** · UNIVERSITY OF WASHINGTON · 2020 · $238,049

## Abstract

Approximately 25% of the millions of veterans (est. 8.92 million FY 2013) enrolled for care in Veterans Health
Administration (VHA) have diabetes mellitus, and diabetic macular edema (DME) is the leading cause of vision
loss in the adult diabetic population world-wide. Although diabetic retinopathy has been well-studied,
comparatively little is known about the burden of DME. In fact, only two national prevalence studies and no
national study on the incidence of DME in persons with type 2 diabetes have been conducted. Similarly many
risk factors have been characterized for DR, but no large studies have established predictors for DME.
 Beyond the Medicare claims database, the VHA National Patient Care Database (NPCD) contains
standardized administrative data for several aspects of patient care including diagnoses, procedures,
medications, lab test results, vital signs, clinical text notes, and mortality. Because the VA uses teleretinal
screening as routine clinical care for all patients with diabetes with these results included in the NPCD, the
NPCD is an ideal source for studying the epidemiology of and risk factors for DME.
 This study proposes to determine the burden of diabetic macular edema, establish risk factors, and
examine treatment outcomes in a previously extracted dataset on 1.98 million veterans who have undergone
diabetic retinopathy screening at least once since 2004. Currently invaluable ophthalmic data are encoded in
unstructured clinical encounter notes in the Computerized Patient Record System (CPRS), and no validated
automated extraction method exists to capture these data elements. An automated extraction method using
natural language processing will be created and validated to unlock key ophthalmic variables. These text
extraction methods will be applicable to extracting ophthalmology data from not only notes of patients with
DME but also any ophthalmology clinical note. This will enable future large scale studies in ophthalmology
using NPCD and be immediately valuable to the research community at large.
 The candidate, Dr. Aaron Lee, MD MSCI, is an ophthalmologist with subspecialty training in retina
surgery with a strong background in computer science and epidemiology. His career goal is to become an
independent clinician scientist studying diabetic eye disease with large-scale electronic medical record
extracted data. While he possesses the foundational skills, he seeks to gain training in advanced statistics and
natural language processing to unlock the data captured in unstructured clinical encounter notes. He has
assembled an outstanding mentorship team under the primary mentor, Dr. Edward Boyko, MD MPH. This
mentorship team includes renowned experts in clinical epidemiology, health informatics, ophthalmology, and
natural language processing. This K23 will provide Dr. Lee the structured coursework, mentorship, and applied
learning needed to acquire new research skills. He will leverage key local resources to carry out th...

## Key facts

- **NIH application ID:** 9995499
- **Project number:** 5K23EY029246-03
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Aaron Lee
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $238,049
- **Award type:** 5
- **Project period:** 2018-09-01 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9995499

## Citation

> US National Institutes of Health, RePORTER application 9995499, Epidemiology and clinical outcomes of diabetic macular edema (5K23EY029246-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9995499. Licensed CC0.

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