Evidence mapPaperPMID 29135987Full record

ArticlePloS one2017

Determining the optimal screening interval for type 2 diabetes mellitus using a risk prediction model.

Andrei Brateanu, Thomas Barwacz, Lei Kou, Sihe Wang, Anita D Misra-Hebert, Bo Hu, Abhishek Deshpande, Nana Kobaivanova, Michael B Rothberg

Abstract read
In one paragraph

Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Andrei BrateanuMedicine Institute, Cleveland Clinic, Cleveland OH, United States of America.ORCID http://orcid.org/0000-0003-1339-3934
Thomas BarwaczDepartment of Medicine, University Hospitals, Cleveland OH, United States of America.
Lei KouQuantitative Health Sciences, Cleveland Clinic, Cleveland OH, United States of America.
Sihe WangPathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland OH, United States of America.
Anita D Misra-HebertMedicine Institute, Cleveland Clinic, Cleveland OH, United States of America.
Bo HuQuantitative Health Sciences, Cleveland Clinic, Cleveland OH, United States of America.
Abhishek DeshpandeMedicine Institute, Cleveland Clinic, Cleveland OH, United States of America.
Nana KobaivanovaMedicine Institute, Cleveland Clinic, Cleveland OH, United States of America.
Michael B RothbergMedicine Institute, Cleveland Clinic, Cleveland OH, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProgression to diabetes mellitus (DM) is variable and the screening time interval not well defined. The American Diabetes Association and US Preventive Services Task Force suggest screening every 3 years, but evidence is limited. The objective of the study was to develop a model to predict the probability of developing DM and suggest a risk-based screening interval.

methodsWe included non-diabetic adult patients screened for DM in the Cleveland Clinic Health System if they had at least two measurements of glycated hemoglobin (HbA1c), an initial one less than 6.5% (48 mmol/mol) in 2008, and another between January, 2009 and December, 2013. Cox proportional hazards models were created. The primary outcome was DM defined as HbA1C greater than 6.4% (46 mmol/mol). The optimal rescreening interval was chosen based on the predicted probability of developing DM.

resultsOf 5084 participants, 100 (4.4%) of the 2281 patients with normal HbA1c and 772 (27.5%) of the 2803 patients with prediabetes developed DM within 5 years. Factors associated with developing DM included HbA1c (HR per 0.1 units increase 1.20; 95%CI, 1.13-1.27), family history (HR 1.31; 95%CI, 1.13-1.51), smoking (HR 1.18; 95%CI, 1.03-1.35), triglycerides (HR 1.01; 95%CI, 1.00-1.03), alanine aminotransferase (HR 1.07; 95%CI, 1.03-1.11), body mass index (HR 1.06; 95%CI, 1.01-1.11), age (HR 0.95; 95%CI, 0.91-0.99) and high-density lipoproteins (HR 0.93; 95% CI, 0.90-0.95). Five percent of patients in the highest risk tertile developed DM within 8 months, while it took 35 months for 5% of the middle tertile to develop DM. Only 2.4% percent of the patients in the lowest tertile developed DM within 5 years.

conclusionA risk prediction model employing commonly available data can be used to guide screening intervals. Based on equal intervals for equal risk, patients in the highest risk category could be rescreened after 8 months, while those in the intermediate and lowest risk categories could be rescreened after 3 and 5 years respectively.

Indexed as

AdultAgedDiabetes Mellitus, Type 2FemaleGlycated HemoglobinHumansMaleMiddle AgedProportional Hazards ModelsRiskGlycated Hemoglobin

Identifiers

PMID29135987
PMCPMC5685604

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.