Clinical applicability and cost-effectiveness of DIABSCORE in screening for type 2 diabetes in primary care
Por:
Cristo Rodriguez-Perez, M, Orozco D, Gil V, Dominguez-Coello, S, Almeida-Gonzalez, D, Brito-Diaz, B, Marcelino-Rodriguez, I, Concepcion Carratala-Munuera, M, Gomez-Moreno, N, Navarro-Perez, J, Brotons-Munto, F, Pertusa-Martinez, S and Cabrera de Leon, A
Publicada:
1 ago 2017
Resumen:
Aims: To evaluate the applicability and cost-effectiveness of a clinical risk score (DIABSCORE) to screen for type 2 diabetes in primary care patients.
Methods: Multicenter cross-sectional study of 10,508 adult no previously diagnosed with diabetes, in 2 Spanish regions (Canary Islands and Valencian Community). The variables comprising DIABSCORE were age, waist to height ratio, family history of diabetes and gestational diabetes. ROC curves were obtained; the diabetes prevalences odds ratios (HbA1c >= 6.5%) between patients exposed and not exposed to DIABSCORE >= 100, and to fasting blood glucose >= 126 mg/dL were calculated. The opinions of both the professionals and the patients concerning DIABSCORE were collected, and a cost-effectiveness analysis was performed.
Results: In both regions, the valid cut-off point for diabetes (DIABSCORE = 100), showed an area under the curve >0.80. The prevalences odds ratio of diabetes for DIABSCORE >= 100 was 9.5 (3.7-31.5) in Canarian and 18.3 (8.0-51.1) in Valencian; and for glucose >= 126 mg/dL it was, respectively, 123.0 (58.8-259.2) and 303.1 (162.5-583.8). However, glucose >= 126 mg/dL showed a low sensitivity (below 48% in both communities) as opposed to DIABSCORE >= 100 (above 90% in both regions). Professionals (100%) and patients (75%) satisfaction was greater when using DIABSCORE rather than glucose measurement for diabetes screening. The cost of each case of diabetes identified was lower with DIABSCORE >= 100 (7.6 (sic) in Canarian and 8.3 (sic) in Valencian) than glucose >= 126 mg/dL (10.8 (sic) and 10.5 (sic), respectively).
Conclusions: DIABSCORE is an applicable and cost-effective screening method for type 2 diabetes in primary care. (C) 2017 Elsevier B.V. All rights reserved.
Filiaciones:
Cristo Rodriguez-Perez, M:
Primary Care Res Unit, Tenerife, Spain
Ntra Sra de Candelaria Univ Hosp, Tenerife, Spain
Orozco D:
Miguel Hernandez Univ, Dept Clin Med, Alicante, Spain
Gil V:
Miguel Hernandez Univ, Dept Clin Med, Alicante, Spain
Dominguez-Coello, S:
Primary Care Res Unit, Tenerife, Spain
Ntra Sra de Candelaria Univ Hosp, Tenerife, Spain
La Victoria Hlth Ctr, Tenerife, Spain
Almeida-Gonzalez, D:
Primary Care Res Unit, Tenerife, Spain
Ntra Sra de Candelaria Univ Hosp, Tenerife, Spain
Brito-Diaz, B:
Primary Care Res Unit, Tenerife, Spain
Ntra Sra de Candelaria Univ Hosp, Tenerife, Spain
Marcelino-Rodriguez, I:
Primary Care Res Unit, Tenerife, Spain
Ntra Sra de Candelaria Univ Hosp, Tenerife, Spain
Concepcion Carratala-Munuera, M:
Miguel Hernandez Univ, Dept Clin Med, Alicante, Spain
:
Miguel Hernandez Univ, Dept Clin Med, Alicante, Spain
Navarro-Perez, J:
Univ Valencia, Dept Med, Valencia, Spain
CIBERESP, Madrid, Spain
:
Carinyena Hlth Ctr, Vila Real, Castellon, Spain
Pertusa-Martinez, S:
Miguel Hernandez Univ, Dept Clin Med, Alicante, Spain
Cabrera de Leon, A:
Primary Care Res Unit, Tenerife, Spain
Ntra Sra de Candelaria Univ Hosp, Tenerife, Spain
La Laguna Univ, Dept Prevent Med, Tenerife, Spain
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