开始时的年龄和查检测2型糖尿病的频率:一个成本效益分析
Richard Kahn1, Peter Alperin, David Eddy
1American Diabetes Association, Alexandria, VA, USA. rak6200@gmail.com
Lancet (London, England)
|April 2, 2010
概括
对2型糖尿病的查在30-45岁之间开始,每3-5年重复一次,成本效益高. 这种方法减少了并发症,并改善了质量调整寿命年 (QALY).
科学领域:
- 预防医学 预防医学
- 卫生经济学 卫生经济学
- 流行病学 流行病学
背景情况:
- 没有任何临床试验评估了2型糖尿病的顺序查策略.
- 数学建模用于估计各种查策略的成本效益.
研究的目的:
- 估计不同类型2糖尿病查策略的成本效益.
- 为了比较顺序查与没有查.
主要方法:
- 使用阿基米德模型创建了一个模拟的美国人口325,000个30岁以上没有糖尿病的个体.
- 八种查策略 (根据年龄和频率而异) 与没有查的对照组进行了比较.
- 结果包括2型糖尿病发病率,心肌梗塞,中风,微血管并发症,生活质量,成本和每QALY的成本.
主要成果:
- 所有的查策略都减少了心肌梗塞和微血管并发症,并在50年内增加了QALY.
- 五个策略的每QALY成本约为10,500美元或更低.
- 较高的成本与较晚的开始年龄和更频繁的查间隔有关.
结论:
- 在美国人口中,如果在30至45岁之间开始,那么2型糖尿病查是具有成本效益的.
- 建议每3-5年重复查,以获得最佳的成本效益.
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