Global cost-effectiveness of GDM screening and management: Current knowledge and future needs
Global cost-effectiveness of GDM screening and management: Current knowledge and future needs
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DOI：
10.1016/j.bpobgyn.2014.06.009
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发表时间：
2015-02-01
影响因子：
5.5
通讯作者：
Lohse, Nicolai
中科院分区：
文献类型：
--
作者：
Weile, Louise K. K.;Kahn, James G.;Lohse, Nicolai
妊娠期糖尿病(GDM)是妇女及其后代发病率增加的原因。筛查和干预可以减少围产期和最有可能的长期糖尿病后果。已经有很多经济研究，但最近没有进行系统的比较。从2002年到2014年，我们对成本效益和成本效用进行了系统的检索和提炼。我们将所有调查结果标准化为2014美元。我们发现，成本效益比差异很大。大多数差异被发现是由于地理环境、诊断标准和干预方法以及结果(例如，包括或排除长期2型糖尿病风险和相关成本)的差异。我们的结论是，纳入妊娠期糖尿病筛查和治疗的长期益处对成本效益估计有巨大影响。基于现有证据中大量方法的异质性和不同的结果，我们发现概述任何全球建议是不合理的。对于未来的经济研究，我们建议纳入长期结果和适应当地偏好，以及检查国际糖尿病协会(IADPSG)最近提出的诊断标准的影响。(C)2014爱思唯尔有限公司。保留所有权利。
Gestational diabetes mellitus (GDM) is an increasing cause of morbidity in women and their offspring. Screening and intervendon can reduce perinatal and most likely also long-term diabetes consequences. There have been many economic studies, but not recently systematically compared. We conducted a systematic search and abstraction of cost-effectiveness and cost utility studies from 2002 to 2014. We standardized all findings to 2014 US dollars. We found that cost-effectiveness ratios varied widely. Most variation was found to be due to differences in geographic setting, diagnostic criteria and intervention approaches, and outcomes (e.g., inclusion or exclusion of long-term type 2 diabetes risk and associated costs). We concluded that incorporation of long-term benefits of GDM screening and treatment has huge impact on cost-effectiveness estimates. Based on the large methodological heterogeneity and varying results in the existing body of evidence, we find it unreasonable to outline any global recommendations. For future economic studies, we recommend inclusion of long-term outcomes and adaptation to local preferences, as well as examination of the impact of the diagnostic criteria recently proposed by the International Association of Diabetes in Pregnancy Study Groups (IADPSG). (C) 2014 Elsevier Ltd. All rights reserved.