Document Detail


Feasibility of screening for silent myocardial ischaemia according to the ALFEDIAM-SFC 2004 Guidelines in a population of diabetic patients.
MedLine Citation:
PMID:  20434384     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Screening tests have to meet a number of criteria, including feasibility. The aim of this study was to estimate the proportion of the French diabetic population that is eligible for screening for silent myocardial ischaemia (SMI), and to evaluate the feasibility of such screening in the Franche-Comté region. METHODS: Data were taken from the Echantillon National Témoin Représentatif de la Population Diabétique (ENTRED, a Representative National Sample of the Diabetic Population 2001 study), which was based on questionnaires filled out by 3646 diabetic patients. All screening tests carried out in the region of Franche-Comté in eastern France in 2003 were recorded (n=19,216). RESULTS: The guidelines issued by the ALFEDIAM-SFC in 2004 were applied to the ENTRED population and identified 645 diabetic patients (17%) as eligible for SMI screening. When applied to the region of Franche-Comté, the recommendations would have required screening 7480 diabetic patients over a period of 3years, involving 1246 exercise stress tests and 1246 myocardial perfusion or stress echocardiography studies annually. However, more than 14,653 exercise stress, 4248 myocardial perfusion and 315 stress echocardiography tests were carried out in the region in 2003 among diabetic and non-diabetic patients, thus largely covering the screening requirements. On the other hand, ENTRED 2001 data also showed that 60% of patients who reported existing coronary disease would not have met screening criteria. CONCLUSION: The number of examinations carried out in the region of Franche-Comté greatly exceeded the number of patients required for screening. However, practical feasibility is not the only criterion needed to guarantee the quality of a large-scale screening programme. Our results raise the question of the relevance of the current screening selection criteria.
Authors:
A Hiebel; A Fagot-Campagna; S Fosse; M Varroud-Vial; A Weill; A Penfornis
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Diabetes & metabolism     Volume:  36     ISSN:  1878-1780     ISO Abbreviation:  Diabetes Metab.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-24     Completed Date:  2010-11-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607599     Medline TA:  Diabetes Metab     Country:  France    
Other Details:
Languages:  eng     Pagination:  286-92     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Masson SAS. All rights reserved.
Affiliation:
Service d'endocrinologie-métabolisme et diabétologie-nutrition, hôpital Jean-Minjoz, EA3920, université de Franche-Comté, 3, boulevard Fleming, 25030 Besançon cedex, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Diabetes Mellitus, Type 1 / complications
Diabetes Mellitus, Type 2 / complications
Diabetic Angiopathies* / diagnosis,  economics,  epidemiology,  prevention & control
Direct Service Costs
Feasibility Studies
Female
France / epidemiology
Humans
Male
Mass Screening* / economics
Middle Aged
Myocardial Ischemia* / diagnosis,  economics,  epidemiology,  prevention & control
Practice Guidelines as Topic
Questionnaires
Risk Assessment
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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