| Screening for gestational diabetes mellitus: cost-utility of different screening strategies based on a woman's individual risk of disease. | |
| | |
MedLine Citation:
|
PMID: 20809381 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
AIMS/HYPOTHESIS: The cost-effectiveness of eight strategies for screening for gestational diabetes (including no screening) was estimated with respect to the level of individual patient risk. METHODS: Cost-utility analysis using a decision analytic model populated with efficacy evidence pooled from recent randomised controlled trials, from the funding perspective of the National Health Service in England and Wales. Seven screening strategies using various combinations of screening and diagnostic tests were tested in addition to no screening. The primary outcome measure was the incremental cost per quality-adjusted life-year (QALY) over a lifetime. RESULTS: The strategy that has the greatest likelihood of being cost-effective is dependent on the risk of gestational diabetes mellitus for each individual woman. When gestational diabetes mellitus risk is <1% then the no screening/treatment strategy is cost-effective; where risk is between 1.0% and 4.2% fasting plasma glucose followed by OGTT is most likely to be cost-effective; and where risk is >4.2%, universal OGTT is most likely to be cost-effective. However, acceptability of the test alters the most cost-effective strategy. CONCLUSIONS/INTERPRETATION: Screening for gestational diabetes can be cost-effective. The best strategy is dependent on the underlying risk of each individual and the acceptability of the tests used. The current study suggests that if a woman's individual risk of gestational diabetes could be accurately predicted, then healthcare resource allocation could be improved by providing an individualised screening strategy. |
| | |
Authors:
|
J A Round; P Jacklin; R B Fraser; R G Hughes; M A Mugglestone; R I G Holt |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-08-31 |
Journal Detail:
|
Title: Diabetologia Volume: 54 ISSN: 1432-0428 ISO Abbreviation: Diabetologia Publication Date: 2011 Feb |
Date Detail:
|
Created Date: 2011-01-07 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0006777 Medline TA: Diabetologia Country: Germany |
Other Details:
|
Languages: eng Pagination: 256-63 Citation Subset: IM |
Affiliation:
|
Academic Unit of Health Economics, Institute of Health Sciences, University of Leeds, Leeds, UK. j.round@medsch.ucl.ac.uk |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
| Comments/Corrections | |
Comment In:
|
Diabetologia. 2011 Feb;54(2):227-9
[PMID:
21109999
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Real-time adherence monitoring for HIV antiretroviral therapy.
Next Document: Gene-expression profiling in breast cancer: bespoke cancer therapy or more fiction than science?