Estimating the potential population impact of stepwise screening strategies for identifying and treating individuals at high risk of Type 2 diabetes : a modelling study
© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK..
BACKGROUND: Diabetes risk assessment has been proposed as part of the National Health Service Health Checks programme, and HbA(1c) has recently been recommended as a diagnostic test for diabetes at a threshold of 48 mmol/mol (6.5%). We estimated the potential population impact of different stepwise screening strategies to identify individuals at high risk who might be offered preventive interventions.
METHODS: Using data from 5910 participants in the European Prospective Investigation of Cancer (EPIC)-Norfolk cohort with HbA(1c) measurements, we modelled different stepwise screening strategies for identifying and treating individuals at high risk of Type 2 diabetes using different HbA(1c) cut-off points with and without a stage of prestratification. For each strategy, we estimated the number needed to have a diagnostic test, the number needed to treat to prevent one new case of Type 2 diabetes, and the number of new cases that could be prevented in the population over 3 years. Relative risk reductions for estimated effects of intensive lifestyle intervention were derived from the US Diabetes Prevention Program.
RESULTS: Compared with inviting all individuals in an average primary care trust for a diagnostic test, a stepwise screening approach using simple routine data such as age and anthropometric indices could prevent a slightly lower number (lower-upper estimates) of new cases of Type 2 diabetes over 3 years (224 [130-359] and 193 [109-315] cases respectively) but would only require half the population to be invited for a diagnostic blood test. A total of 162 (88-274) cases could be prevented by inviting individuals with a Cambridge risk score of ≥ 0.15, with only 40% of the total population requiring diagnostic blood tests. Using a participant completed questionnaire for risk assessment (FINDRISC) was less effective, mainly relating to the questionnaire response rate. Providing preventive interventions to those with a lower HbA(1c) of 37-< 48 mmol/mol (5.5-< 6.5%) could prevent more cases but with a disproportionately higher workload, compared with using the recommended HbA(1c) threshold of 42-< 48 mmol/mol (6.0-< 6.5%).
CONCLUSIONS: Compared with mass screening, an approach using routine data for risk stratification followed by an HbA(1c) test with a threshold of 42-< 48 mmol/mol (6.0-< 6.5%) for identifying individuals suitable for preventive interventions might prevent slightly fewer cases of Type 2 diabetes but with potential cost-savings.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2012 |
|---|---|
| Erschienen: |
2012 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
|---|---|
| Enthalten in: |
Diabetic medicine : a journal of the British Diabetic Association - 29(2012), 7 vom: 15. Juli, Seite 893-904 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Chamnan, P [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 16.11.2012 Date Revised 15.11.2023 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1111/j.1464-5491.2012.03609.x |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM215472128 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM215472128 | ||
| 003 | DE-627 | ||
| 005 | 20231224025612.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231224s2012 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/j.1464-5491.2012.03609.x |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0718.xml |
| 035 | |a (DE-627)NLM215472128 | ||
| 035 | |a (NLM)22340130 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Chamnan, P |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Estimating the potential population impact of stepwise screening strategies for identifying and treating individuals at high risk of Type 2 diabetes |b a modelling study |
| 264 | 1 | |c 2012 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.11.2012 | ||
| 500 | |a Date Revised 15.11.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK. | ||
| 520 | |a BACKGROUND: Diabetes risk assessment has been proposed as part of the National Health Service Health Checks programme, and HbA(1c) has recently been recommended as a diagnostic test for diabetes at a threshold of 48 mmol/mol (6.5%). We estimated the potential population impact of different stepwise screening strategies to identify individuals at high risk who might be offered preventive interventions | ||
| 520 | |a METHODS: Using data from 5910 participants in the European Prospective Investigation of Cancer (EPIC)-Norfolk cohort with HbA(1c) measurements, we modelled different stepwise screening strategies for identifying and treating individuals at high risk of Type 2 diabetes using different HbA(1c) cut-off points with and without a stage of prestratification. For each strategy, we estimated the number needed to have a diagnostic test, the number needed to treat to prevent one new case of Type 2 diabetes, and the number of new cases that could be prevented in the population over 3 years. Relative risk reductions for estimated effects of intensive lifestyle intervention were derived from the US Diabetes Prevention Program | ||
| 520 | |a RESULTS: Compared with inviting all individuals in an average primary care trust for a diagnostic test, a stepwise screening approach using simple routine data such as age and anthropometric indices could prevent a slightly lower number (lower-upper estimates) of new cases of Type 2 diabetes over 3 years (224 [130-359] and 193 [109-315] cases respectively) but would only require half the population to be invited for a diagnostic blood test. A total of 162 (88-274) cases could be prevented by inviting individuals with a Cambridge risk score of ≥ 0.15, with only 40% of the total population requiring diagnostic blood tests. Using a participant completed questionnaire for risk assessment (FINDRISC) was less effective, mainly relating to the questionnaire response rate. Providing preventive interventions to those with a lower HbA(1c) of 37-< 48 mmol/mol (5.5-< 6.5%) could prevent more cases but with a disproportionately higher workload, compared with using the recommended HbA(1c) threshold of 42-< 48 mmol/mol (6.0-< 6.5%) | ||
| 520 | |a CONCLUSIONS: Compared with mass screening, an approach using routine data for risk stratification followed by an HbA(1c) test with a threshold of 42-< 48 mmol/mol (6.0-< 6.5%) for identifying individuals suitable for preventive interventions might prevent slightly fewer cases of Type 2 diabetes but with potential cost-savings | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Simmons, R K |e verfasserin |4 aut | |
| 700 | 1 | |a Khaw, K T |e verfasserin |4 aut | |
| 700 | 1 | |a Wareham, N J |e verfasserin |4 aut | |
| 700 | 1 | |a Griffin, S J |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Diabetic medicine : a journal of the British Diabetic Association |d 1993 |g 29(2012), 7 vom: 15. Juli, Seite 893-904 |w (DE-627)NLM012664030 |x 1464-5491 |7 nnns |
| 773 | 1 | 8 | |g volume:29 |g year:2012 |g number:7 |g day:15 |g month:07 |g pages:893-904 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/j.1464-5491.2012.03609.x |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 29 |j 2012 |e 7 |b 15 |c 07 |h 893-904 | ||