Know Your Number Aggregate Report Comparison Analysis Between Baseline & Follow-up

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Leo Austin
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.. Time Window of Baseline: 09/01/13 to 12/20/13.

1 Know Your Number Aggregate Report Comparison Analysis Between Baseline & Follow-up... Study Population: Total Population: Time Window of Baseline: 09/01/13 to 12/20/13... Time Window of Follow-up: 08/04/14 to 12/14/ Version of Report: V Know Your Number Powered by BIOSIGNIA

Page 2 Participants Included and/or Excluded from Report Baseline Follow-up Number of participants 404 434 Number of KYN records 404 434 Number of participants with KYN

340 Note: If more than one KYN record existed for a given participant in the time window selected, the earliest baseline record and the most recent follow-up record were

If applicable, participants were excluded from this report if:¹ Number of baseline participants excluded Number of follow-up participants excluded Currently pregnant 3 0

Triglycerides: < 1 mg/dl or > 2000 mg/dl 0 0 Total cholesterol: < 1 mg/dl or > 999 mg/dl 0 0 Fasting glucose: < 1 mg/dl or > 500 mg/dl 0 0 Pulse rate: < 10 bpm or > 500

2 Page 2 Participants Included and/or Excluded from Report Baseline Follow-up Number of participants Number of KYN records Number of participants with KYN record(s) in both Baseline and Follow-up Total number of participants excluded due to reasons listed below Total number of participants included in present analysis Note: If more than one KYN record existed for a given participant in the time window selected, the earliest baseline record and the most recent follow-up record were selected. If applicable, participants were excluded from this report if:¹ Number of baseline participants excluded Number of follow-up participants excluded Currently pregnant 3 0 Age: < 21 years or > 80 years 1 0 Required risk factor entered as range or unknown 2 0 Risk factor with outlier values as follows: HDL: < 1 mg/dl or > 500 mg/dl 0 0 Triglycerides: < 1 mg/dl or > 2000 mg/dl 0 0 Total cholesterol: < 1 mg/dl or > 999 mg/dl 0 0 Fasting glucose: < 1 mg/dl or > 500 mg/dl 0 0 Pulse rate: < 10 bpm or > 500 bpm 0 0 Waist measurement: < 0 inches or > 100 inches 0 0 Body weight: < 36 pounds or > 800 pounds 0 0 Diastolic blood pressure: < 10 mmhg or > 500 mmhg 0 0 Systolic blood pressure: < 10 mmhg or > 500 mmhg 0 0 Height: < 2 feet or > 10 feet 0 0 ¹ Participants who meet more than one exclusion criteria may be included in multiple categories.

3 Page 3 Study Population Demographics Gender Number % Male Female Total % 37.4% Male Female 40 Age (years) Number % Total Percentage Age (years) Race Number % White Black Asian Hispanic Others Total White Black Asian Hispanic Others Note: Values throughout this report have been rounded for ease of presentation.

4 Page 4 Health Status and Risk Factor Profile: Changes Between Baseline and Follow-up Evaluations Clinical Measures Baseline (%) Follow-up (%) Difference¹ (%) Change² (%) Metabolic syndrome³ Overweight (BMI kg/m²) Obese (BMI 30 kg/m²) Large waist (males > 40", females > 35") Prehypertensive (120/80-139/89 mmhg) Hypertensive ( 140/90 mmhg) Total cholesterol 200 mg/dl HDL < 40 mg/dl LDL 130 mg/dl LDL ATP III-suggested goal Triglycerides 150 mg/dl Undiagnosed diabetic (glucose 126 mg/dl) Prediabetic (glucose mg/dl) Self-reported Conditions Diabetes Coronary Heart Disease Stroke Congestive Heart Failure Other Cardiovascular Diseases Hypertension⁴ Hyperlipidemia⁴ On antihypertensive medication On lipid-lowering medication Current smoker Physical exercise level Low Moderate ¹ Difference (%) = Follow-up (%) minus Baseline (%) ² Change (%) = Difference (%) divided by Baseline (%) ³ The metabolic syndrome categorization, as described in the ATP III guideline, includes only those surveyed participants who reported actual values for triglycerides, HDL, blood pressure, and glucose. Participants reporting Unknown or categorical ranges for these data points are excluded from the metabolic syndrome categorization. ⁴ Condition not applicable for KYN v2 questionnaire models.

5 Page 5 Health Status and Risk Factor Profile: Changes Between Baseline & Follow-up (continued) Males Clinical Measures Baseline (%) Follow-up (%) Difference (%) Change (%) Metabolic syndrome Overweight (BMI kg/m²) Obese (BMI 30 kg/m²) Waist circumference > 40 inches Prehypertensive (120/80-139/89 mmhg) Hypertensive ( 140/90 mmhg) Total cholesterol 200 mg/dl HDL < 40 mg/dl LDL 130 mg/dl LDL ATP III-suggested goal Triglycerides 150 mg/dl Undiagnosed diabetic (glucose 126 mg/dl) Prediabetic (glucose mg/dl) Self-reported Conditions Diabetes Coronary Heart Disease Stroke Congestive Heart Failure Other Cardiovascular Diseases Hypertension Hyperlipidemia On antihypertensive medication On lipid-lowering medication Current smoker Physical exercise level Low Moderate

6 Page 6 Health Status and Risk Factor Profile: Changes Between Baseline & Follow-up (continued) Females Clinical Measures Baseline (%) Follow-up (%) Difference (%) Change (%) Metabolic syndrome Overweight (BMI kg/m²) Obese (BMI 30 kg/m²) Waist circumference > 35 inches Prehypertensive (120/80-139/89 mmhg) Hypertensive ( 140/90 mmhg) Total cholesterol 200 mg/dl HDL < 40 mg/dl LDL 130 mg/dl LDL ATP III-suggested goal Triglycerides 150 mg/dl Undiagnosed diabetic (glucose 126 mg/dl) Prediabetic (glucose mg/dl) Self-reported Conditions Diabetes Coronary Heart Disease Stroke Congestive Heart Failure Other Cardiovascular Diseases Hypertension Hyperlipidemia On antihypertensive medication On lipid-lowering medication Current smoker Physical exercise level Low Moderate

7 Page 7 Mean Clinical Measures: Changes Between Baseline and Follow-up Evaluations Clinical Measures Weight (pounds) BMI (kg/m²) Waist (inches) Systolic blood pressure (mmhg) Diastolic blood pressure (mmhg) Total cholesterol (mg/dl) HDL cholesterol (mg/dl) LDL cholesterol (mg/dl) Triglycerides (mg/dl) Fasting glucose (mg/dl) Weight (pounds) BMI (kg/m²) Waist (inches) Systolic blood pressure (mmhg) Diastolic blood pressure (mmhg) Total cholesterol (mg/dl) HDL cholesterol (mg/dl) LDL cholesterol (mg/dl) Triglycerides (mg/dl) Fasting glucose (mg/dl) Weight (pounds) BMI (kg/m²) Waist (inches) Systolic blood pressure (mmhg) Diastolic blood pressure (mmhg) Total cholesterol (mg/dl) HDL cholesterol (mg/dl) LDL cholesterol (mg/dl) Triglycerides (mg/dl) Fasting glucose (mg/dl) Baseline (%) Follow-up (%) Difference¹ (%) Change² (%) Study Population Males Females ¹ Difference (%) = Follow-up (%) minus Baseline (%) ² Change (%) = Difference (%) divided by Baseline (%)

8 Page 8 Distribution of Population Disease Risks by Percentile DIABETES Above Below Low CORONARY HEART DISEASE Above Below Low Baseline 22% 18% 22% 17% 21% Baseline 15% 2 22% 22% 21% Follow-up 16% 21% 17% 21% 25% Follow-up 11% % 23% Baseline N¹ = 297 Baseline N = 340 Follow-up N = 294 Follow-up N = % 25% % 15% 1 1 5% 5% Above Below Low Above Below Low STROKE CONGESTIVE HEART FAILURE Above Below Low Above Below Low Baseline 23% 22% 25% 14% 16% Baseline 2 27% 2 16% 17% Follow-up 19% 21% 25% 18% 17% Follow-up 21% 18% 23% 19% 19% Baseline N = 340 Baseline N = % 2 15% 1 5% Follow-up N = 340 Follow-up N = % 2 15% 1 5% Above Below Low Above Below Low Disease risk is classified by an age- and gender-specific risk percentile as follows: Above Below Low 80th percentile 60th and < 80th percentile 40th and < 60th percentile 20th and < 40th percentile < 20th percentile No data are available for COPD and lung cancer because those models were only run for smokers. ¹ N refers to the number of people who received a KYN risk percentile for the specific disease. Self-reported diabetics and participants with a fasting glucose 126 mg/dl are excluded from the diabetes assessment. Individuals reporting a prior stroke event may be excluded from the stroke assessment. Self-reported heart failure diagnosis and individuals under the age of 41 years are excluded from the congestive heart failure assessment.

9 Date of Report: 07/21/15 Page 9 Projected Number of Total¹, Avoidable², and Inherent³ Cases of Disease Onset Within the Next Five Years: Changes Between Baseline & Follow-up Study Population N = 340 Disease Baseline Follow-up Change Total Avoidable Total Avoidable Total Avoidable Diabetes % -14% CHD % -1 Stroke CHF % -16% COPD % -1% Lung Cancer % -22% Total % -13% Number of Cases Contribution of Risk Factors to Avoidable Cases Risk Factor Weight Blood Pressure Exercise Smoking Cholesterol Glucose Total Avoidable Cases Baseline Follow-up Change -13% -1-9% -14% -11% -4-13% ¹ "Total cases" is the projected number of new cases in the study population over the next 5 years. ² "Avoidable cases" is the number of new cases that may be avoided in the next 5 years if all modifiable risk factors are brought within the normal range. ³ Inherent cases is the projected number of new cases in the next 5 years attributed to nonmodifiable risk and modifiable risk factors within normal range.

10 Date of Report: 07/21/15 Page 10 Projected Number of Total¹, Avoidable², and Inherent³ Cases of Disease Onset Within the Next Five Years: Changes Between Baseline & Follow-up Extrapolation⁴ to Total Population Total Population N = 500 Disease Baseline Follow-up Change Total Avoidable Total Avoidable Total Avoidable Diabetes % -14% CHD % -1 Stroke CHF % -16% COPD % -1% Lung Cancer % -22% Total % -13% 25 Number of Cases Contribution of Risk Factors to Avoidable Cases Risk Factor Avoidable Cases Baseline Follow-up Change Weight % Blood Pressure Exercise % Smoking % Cholesterol % Glucose Aspirin Total % ¹ "Total cases" is the projected number of new cases in the study population over the next 5 years. ² "Avoidable cases" is the number of new cases that may be avoided in the next 5 years if all modifiable risk factors are brought within the normal range. ³ Inherent cases is the projected number of new cases in the next 5 years attributed to nonmodifiable risk and modifiable risk factors within normal range. ⁴ This extrapolation assumes that the study population is a representative subset of the larger total population.

11 Page 11 Projected Five-year Cost¹ of Future Chronic Disease Onset: Changes Between Baseline and Follow-up Study Population² Study Population N = 340 Diseases Baseline Follow-up Difference³ Diabetes $512,958 $448,774 -$64,185 Coronary Heart Disease $382,360 $363,610 -$18,750 Stroke $165,071 $148,350 -$16,722 Congestive Heart Failure $82,452 $77,168 -$5,284 COPD $41,817 $41,222 -$595 Lung Cancer $114,824 $82,055 -$32,769 All Diseases $1,299,483 $1,161,178 -$138,305 Extrapolation to Total Population⁴ Total Population N = 500 Diseases Baseline Follow-up Difference Diabetes $754,351 $659,962 -$94,389 Coronary Heart Disease $562,294 $534,720 -$27,574 Stroke $242,752 $218,161 -$24,591 Congestive Heart Failure $121,253 $113,482 -$7,771 COPD $61,496 $60,621 -$875 Lung Cancer $168,859 $120,670 -$48,189 All Diseases $1,911,004 $1,707,615 -$203,389 ¹ Projected costs = R * C * ( * I * I² * I³ + I⁴) 5 R = 5-year estimated total cases in study population; C = assumed annual disease cost (noted below), I = annual inflation rate + 1 ² Study population is the population who participated in Know Your Number. ³ Difference = Follow-up projected costs minus Baseline projected costs. ⁴ This extrapolation assumes that the study population is a representative subset of the larger total population. The KYN disease costs are based on annual estimates and include direct and indirect medical costs associated with the occurrence of each disease. Estimates are calculated using recent average U.S. costs as reported by the American Diabetes Association, the American Heart Association, the American Stroke Association, the American Lung Association, the National Heart Lung and Blood Institute, and the National Cancer Institute. The estimated, per-participant costs used in this report are as follows: diabetes = $11,036; coronary heart disease = $13,273; stroke = $10,838; heart failure = $7,686; COPD = $3,929; and lung cancer = $120,799, with an assumed annual inflation rate = 6%

12 Date of Report: 07/21/15 Page 12 KYN Risk Tracker¹: Population Analysis Study Population² N = 340 Baseline Value: 69 Follow-up Value: 66 Classification: Optimal Normal Above Normal Borderline Extremely Ranges: Baseline 0.6% 9.1% % 18.2% 10.3% Follow-up 1.2% 10.9% 30.3% 32.6% 16.8% 8.2% Change 0.6% 1.8% 0.3% 0.9% -1.5% -2.1% 4 Baseline Compared to Follow-up Baseline Follow-up Optimal Normal Above Normal Borderline Extremely KYN Risk Tracker Value by Classification: Focus on the Baseline Cohort³ Extremely Borderline Above Normal Normal Optimal Baseline Baseline Cohort at Follow-up Difference Avoidable Disease Burden Cost: Focus on the Baseline Cohort³ Baseline Extremely $285,312 $268,858 Borderline $254,127 Above Normal $56,987 Normal $1,329 Optimal $0 Total $866,613 Baseline Cohort at Follow-up $232,474 $240,641 $207,731 $60,859 $1,839 $26 $743,571 Difference -$52,838 -$28,217 -$46,396 $3,872 $510 $26 -$123,041 ¹ KYN Risk Tracker is a summation of a participant's overall health risk based on their individual disease risk for diabetes, CHD, and stroke combined with other biometric and clinical risk factor contributions. ² Includes only those participants with a KYN Risk Tracker value at both baseline and follow-up assessments. ³ Baseline cohort: a subgroup of baseline participants evaluated at the follow-up interval (i.e., same individuals at both time periods).

13 Date of Report: 07/21/15 Page 13 KYN Risk Tracker: Population Analysis (continued) Extremely Borderline Above Normal Normal Optimal Movement between KYN Risk Tracker Classifications: Baseline to Follow-up Baseline # participants Follow-up # participants Moved In Change Moved Out Percentage % % % % Net Detailed Participant Movement between KYN Risk Tracker Classifications: Baseline to Follow-up Follow-up Extremely Borderline Above Normal Normal Optimal Extremely Baseline Borderline Above Normal Normal Optimal Values highlighted along the diagonal (middle) show participants who remained in the same risk category at baseline and follow-up evaluations. Values above the diagonal (lighter shading in upper right) show participants who lowered their risk category between baseline and follow-up. Values below the diagonal (darker shading in lower left) show participants who had an increase in risk category between baseline and follow-up periods. Overall Population Movement Summary No Change Increased Risk Classification Decreased Risk Classification # Participants Percentage % %

14 Wellness Assessment: Changes Between Baseline & Follow-up¹ Dietary Assessment N = 133 Baseline Follow-up Difference² fat 29.3% 39.8% 10.5% Low fruit / vegetable 20.3% 8.3% -12. Others³ 50.4% 51.9% 1.5% Readiness to Change⁴ Diet N = 38 Pre- Contemplation 18.4% 23.7% 5.3% Preparation / Action 68.4% 52.6% -15.8% Maintenance 13.2% 23.7% 10.5% Distribution of Readiness to Change (Diet): Baseline to Follow-up Pre- Contemplation Preparation / Action Maintenance Page 14 N = 122 Readiness to Change Weight Baseline Follow-up Difference Overweight ( kg/m²) Pre-Contemplation 4.9% 5.7% 0.8% Contemplation 21.3% 18.9% -2.5% Preparation 14.8% 13.1% -1.6% Action 3.3% % Maintenance 3.3% % Obese ( 30 kg/m²) Pre-Contemplation Contemplation 12.3% 13.9% 1.6% Preparation % -0.8% Action 8.2% 8.2% 0. Maintenance Total Pre-Contemplation 4.9% 5.7% 0.8% Contemplation 33.6% 32.8% -0.8% Preparation 46.7% 44.3% -2.5% Action 11.5% 17.2% 5.7% Maintenance 3.3% % Distribution of Readiness to Change (Weight): Baseline to Follow-up ¹ Comparisons are made only between participants who answered the applicable questions at baseline and follow-up evaluations and are reflected in the sample size (N). ² Difference (%) = Follow-up (%) minus Baseline (%) ³ "Others" refers to any participants who do not consume a high fat or low fruit / vegetable diet. These participants are excluded from the Readiness-to-Change table. ⁴ See appendix for Readiness-to-Change Category Explanations. N/A: To maintain privacy, at least 25 participants must complete the corresponding assessment for results to be reported.

15 Page 15 Wellness Assessment (continued) Readiness to Change Exercise Level¹ N = 104 Baseline Follow-up Difference Pre-Contemplation 5.8% 12.5% 6.7% Contemplation / Preparation % 4.8% Action 19.2% 7.7% -11.5% 10 5 Distribution of Readiness to Change (Exercise): Baseline to Follow-up Pre-Contemplation Contemplation / Preparation Action Readiness to Change Smoking Cessation² N = 29 Baseline Follow-up Difference Pre-Contemplation 10.3% 6.9% -3.4% Contemplation 13.8% 10.3% -3.4% Preparation 10.3% 6.9% -3.4% Action 3.4% 6.9% 3.4% Maintenance 62.1% % Distribution of Readiness to Change (Smoking): Baseline to Follow-up N = 93 Stress Status Baseline Follow-up Difference Low 69.9% 95.7% 25.8% Moderate 9.7% 1.1% -8.6% 20.4% 3.2% -17.2% N = 218 Depression Assessment³ Baseline Follow-up Difference Score > % 0.9% -12.4% 10 5 Distribution of Stress Status: Baseline to Follow-up Low Moderate ¹ Only participants classified as "moderate" or "low" exercise level evaluation were included. ² Only participants who responded as "current smokers" or "past smokers" were included. ³ Using the Depression Scale Questionnaire from the Center for Epidemiological Studies, a score greater than 8 indicates possible depression.

16 Appendix: Readiness-to-Change Category Explanations Categories listed below correspond to the associated questionnaire responses. Page 16 Nutrition Pre-Contemplation Preparation / Action Maintenance Weight Pre-Contemplation Contemplation Preparation Action Maintenance Exercise Pre-Contemplation Contemplation / Preparation Action Smoking Which of the following best describes your attitude toward your eating habits? I am satisfied with what I eat and have no plans to change it. I would like to reduce the amount of unhealthy foods I eat and adopt a healthier diet. I recently made significant changes to my eating habits. Which of the following best describes your attitude toward your body weight? I do not have a problem with my body weight, and I do not need to lose weight. I have a small problem with my weight, and I should lose some. I am trying not to gain more weight. I am seriously considering trying to lose weight to reach my weight goal in the next 6 months. I have started losing weight within the last 6 months. I am trying to reach my weight goal in the next 6 months. I have kept off the weight I lost more than 6 months ago. Which of the following best describes your attitude toward physical exercise? I do not need more physical exercise. I would like to exercise more. I have just recently started or at least seriously considered exercising more. If you currently smoke, answer the following Yes or No questions. 1. Do you plan to quit smoking in the next 6 months? 2. Do you plan to quit smoking in the next 30 days? 3. Have you successfully attempted to quit for 24 hours or more in the past year? Pre-Contemplation If answered no to question 1. Contemplation Preparation If answered yes to question 1, but no to one of the other questions. If answered yes to all 3 questions. If you previously smoked, when did you quit? Action Maintenance I quit smoking less than 6 months ago. I quit smoking more than 6 months ago.

Know Your Number Aggregate Report Single Analysis Compared to National Averages

Know Your Number Aggregate Report Single Analysis Compared to National s Client: Study Population: 2242 Population: 3,000 Date Range: 04/20/07-08/08/07 Version of Report: V6.2 Page 2 Study Population Demographics