A comparison of cost per case detected of screening strategies for Type 2 diabetes and impaired glucose regulation: Modelling study
A comparison of cost per case detected of screening strategies for Type 2 diabetes and impaired glucose regulation: Modelling study
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DOI：
10.1016/j.diabres.2012.03.009
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发表时间：
2012-09-01
影响因子：
5.1
通讯作者：
Davies, Melanie J.
中科院分区：
文献类型：
--
作者：
Khunti, Kamlesh;Gillies, Clare L.;Davies, Melanie J.
背景：确定2型糖尿病单独和合并葡萄糖调节障碍的不同筛查策略的每例检测成本。方法：使用来自英国多民族初级保健机构add - leicester筛查研究的数据进行贝叶斯框架建模研究。5794名40-75岁的人（77.4%的欧洲白人；22.6%的南亚人）以前没有已知的糖尿病。我们比较了212种筛查策略，包括血液测试、计算机实践数据评分和风险评分，作为多阶段过程的一部分，这些策略都使用口服葡萄糖耐量试验作为诊断试验。模拟模型是使用对每个案例的预期成本的敏感性估计来创建的。结果：确定的18种最敏感策略的每个病例的估计成本从457英镑到1639英镑（526-1886）不等，1英镑= (sic)1.15)糖尿病和148-913英镑（(sic)170-1050）糖尿病和葡萄糖调节受损。最低成本的糖尿病策略从457英镑到523英镑不等（526-601），包括两阶段筛查策略，一种非侵入性风险分层工具，随后进行血液检查，产生的敏感性从67.1到82.4%。结论：使用无创风险分层工具进行人群筛查，然后进行血液筛查是筛查糖尿病和糖耐量异常的最具成本效益的方法。2012爱思唯尔爱尔兰有限公司版权所有。
Background: To determine a cost per case detected for different screening strategies for both Type 2 diabetes alone and in combination with impaired glucose regulation.Methods: Bayesian framework modelling study using data from the ADDITION-Leicester screening study in UK multi-ethnic primary care setting. There were 5794 people aged 40-75 years (77.4% white European; 22.6% south Asian) without previously known diabetes. We compared 212 screening strategies including blood tests, a computer practice data score and a risk score, as part of a multi-stage process that all used an oral glucose tolerance test as the diagnostic test. Simulation models were created using sensitivity estimates for the expected cost per case.Results: The estimated costs per case identified for the 18 most sensitive strategies varied from 457 pound to 1639 pound ((sic)526-1886, for 1 pound = (sic)1.15) for diabetes and 148-913 pound ((sic)170-1050) for both diabetes and impaired glucose regulation. The lowest costing diabetes strategies ranged from 457 pound to 523 pound ((sic)526-601) involving a two-stage screening strategy, a non-invasive risk stratifying tool followed by a blood test, producing sensitivities ranging from 67.1 to 82.4%.Conclusion: Screening a population using a non-invasive risk stratification tool followed by a screening blood test is the most cost-effective method of screening for diabetes and abnormal glucose tolerance. (C) 2012 Elsevier Ireland Ltd. All rights reserved.