Strategies to Screen for Diabetic Retinopathy in Chinese Patients with Newly Diagnosed Type 2 Diabetes: A Cost-Effectiveness Analysis.
Strategies to Screen for Diabetic Retinopathy in Chinese Patients with Newly Diagnosed Type 2 Diabetes: A Cost-Effectiveness Analysis.
复制标题
中国新诊断 2 型糖尿病患者的糖尿病视网膜病变筛查策略：成本效益分析。
DOI：
10.1097/md.0000000000001989
复制
发表时间：
2015-11
期刊：
影响因子：
1.6
通讯作者：
Wu H
中科院分区：
文献类型：
--
作者：
Wu B;Li J;Wu H
本文提供了补充数字内容，以研究中国新诊断的2型糖尿病(T2 DM)患者不同糖尿病视网膜病变(DR)筛查间隔的成本-效果。中国的医疗体系。中国全科临床环境。建立了一个成本-效果模型来模拟我国新诊断糖尿病患者的病程。不同的DR筛查计划被建模以预测经济结果。为了建立经济模型，我们校准了符合中国流行病学数据的DR进展率，这些数据来自已发表的文献。成本是从中国医疗体系的角度进行估计的，而且这项分析是在一生的范围内进行的。进行单因素方差分析和概率敏感性分析。总成本、视力结果、每个质量调整生命年的成本(QALY)、筛查策略与不筛查策略相比的增量成本-效果比(ICER)。DR筛查在中国新诊断的T2 DM患者中是有效的，与不筛查相比，每隔4年进行一次≥筛查的策略更具成本效益(ICER<；每QALY 7,485美元)。在具有成本效益的策略中，每4年筛查一次的QALY增加幅度最大(11.066)。在诊断为T2 DM时，筛查间隔可能因年龄的不同而显著不同。概率敏感性分析证明了4年间隔筛查策略的成本效益的一致性和稳健性。研究结果表明，与在中国不进行筛查相比，每隔4年进行一次筛查的策略可能比每1到3年进行一次筛查更具成本效益。筛查间隔可根据确诊T2 DM的年龄定制。
Supplemental Digital Content is available in the text To investigate the cost-effectiveness of different screening intervals for diabetic retinopathy (DR) in Chinese patients with newly diagnosed type 2 diabetes mellitus (T2DM). Chinese healthcare system. Chinese general clinical setting. A cost-effectiveness model was developed to simulate the disease course of Chinese population with newly diagnosed with diabetes. Different DR screening programs were modeled to project economic outcomes. To develop the economic model, we calibrated the progression rates of DR that fit Chinese epidemiologic data derived from the published literature. Costs were estimated from the perspective of the Chinese healthcare system, and the analysis was run over a lifetime horizon. One-way and probabilistic sensitivity analyses were performed. Total costs, vision outcomes, costs per quality-adjusted life year (QALY), the incremental cost-effectiveness ratio (ICER) of screening strategies compared to no screening. DR screening is effective in Chinese patients with newly diagnosed T2DM, and screen strategies with ≥4-year intervals were cost-effective (ICER <$7,485 per QALY) compared to no screening. Screening every 4 years produced the greatest increase in QALYs (11.066) among the cost-effective strategies. The screening intervals could be varied dramatically by age at T2DM diagnosis. Probabilistic sensitivity analyses demonstrated the consistency and robustness of the cost-effectiveness of the 4-year interval screening strategy. The findings suggest that a 4-year interval screening strategy is likely to be more cost-effective than screening every 1 to 3 years in comparison with no screening in the Chinese setting. The screening intervals might be tailored according to the age at T2DM diagnosis.