Estimating the potential population impact of stepwise screening strategies for identifying and treating individuals at high risk of Type 2 diabetes: a modelling study

摘要: Diabet. Med. 29, 893–904 (2012) Abstract Background  Diabetes risk assessment has been proposed as part of the National Health Service Checks programme, and HbA1c recently recommended a diagnostic test for diabetes at threshold 48 mmol/mol (6.5%). We estimated potential population impact different stepwise screening strategies to identify individuals high who might be offered preventive interventions. Methods  Using data from 5910 participants in European Prospective Investigation Cancer (EPIC)-Norfolk cohort with measurements, we modelled identifying treating Type 2 using cut-off points without stage prestratification. For each strategy, number needed have test, treat prevent one new case diabetes, cases that could prevented over 3 years. Relative reductions effects intensive lifestyle intervention were derived US Prevention Program. Results  Compared inviting all an average primary care trust approach simple routine such age anthropometric indices slightly lower (lower-upper estimates) 3 years (224 [130–359] 193 [109–315] respectively) but would only require half invited blood test. A total 162 (88–274) by Cambridge score ≥ 0.15, 40% requiring tests. participant completed questionnaire (FINDRISC) was less effective, mainly relating response rate. Providing interventions those 37–< 48 mmol/mol (5.5–< 6.5%) more disproportionately higher workload, compared 42–< 48 mmol/mol (6.0–< 6.5%). Conclusions  mass screening, stratification followed (6.0–< 6.5%) suitable fewer cost-savings.