Comparative effectiveness of guidelines for the management of hyperlipidemia and hypertension for type 2 diabetes patients.
Comparative effectiveness of guidelines for the management of hyperlipidemia and hypertension for type 2 diabetes patients.
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DOI：
10.1371/journal.pone.0016170
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发表时间：
2011-01-25
期刊：
影响因子：
3.7
通讯作者：
Smith SA
中科院分区：
文献类型：
--
作者：
Shah ND;Mason J;Kurt M;Denton BT;Schaefer AJ;Montori VM;Smith SA
在北美、欧洲和澳大利亚，有几个降低糖尿病患者心血管风险的指南。他们是否有能力有效地实现这一目标尚不清楚。采用决策分析方法比较国际现代指南对40-80岁2型糖尿病患者高血压和高脂血症管理的效率和有效性。比较有效性的指标包括冠状动脉或中风事件的预期概率、每次事件的增量药物成本和预防事件所需治疗的数量（NNT）。所有的指南都同样有效，但它们在药物成本上有很大差异。在指南中，预防事件的NNT范围较小（男性为6.5-7.6，女性为6.5-7.5）;观察到避免的每起事件的预期成本差异较大（男性范围为117，269 - 157，186美元，女性范围为115，999 - 163，775美元）。澳大利亚和美国的指导方针分别导致最高和最低的预期成本。基于相同证据和寻求相同目标的国际指南在有效性方面相似;然而，预期的药物费用存在很大差异。
Several guidelines to reduce cardiovascular risk in diabetes patients exist in North America, Europe, and Australia. Their ability to achieve this goal efficiently is unclear. Decision analysis was used to compare the efficiency and effectiveness of international contemporary guidelines for the management of hypertension and hyperlipidemia for patients aged 40–80 with type 2 diabetes. Measures of comparative effectiveness included the expected probability of a coronary or stroke event, incremental medication costs per event, and number-needed-to-treat (NNT) to prevent an event. All guidelines are equally effective, but they differ significantly in their medication costs. The range of NNT to prevent an event was small across guidelines (6.5–7.6 for males and 6.5–7.5 for females); a larger range of differences were observed for expected cost per event avoided (ranges, $117,269–$157,186 for males and $115,999–$163,775 for females). Australian and U.S. guidelines result in the highest and lowest expected costs, respectively. International guidelines based on the same evidence and seeking the same goal are similar in their effectiveness; however, there are large differences in expected medication costs.
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影响因子：
120.7
作者：
Cooper-DeHoff, Rhonda M.;Gong, Yan;Handberg, Eileen M.;Bavry, Anthony A.;Denardo, Scott J.;Bakris, George L.;Pepine, Carl J.
通讯作者：
Pepine, Carl J.
影响因子：
8.3
作者：
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通讯作者：
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影响因子：
120.7
作者：
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通讯作者：
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影响因子：
37.8
作者：
Grundy, SM;Becker, D;Jehle, AJ
通讯作者：
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影响因子：
39.2
作者：
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通讯作者：
Vijan, Sandeep