Evidence map›Paper›PMID 34022872›Full record

ArticleBMC endocrine disorders2021

Cost-effectiveness analysis for HbA1c test intervals to screen patients with type 2 diabetes based on risk stratification.

Sachiko Ohde, Kensuke Moriwaki, Osamu Takahashi

Open access · goldAbstract read
In one paragraph

Article in BMC endocrine disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 36% of its field
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, 6 citations in OpenAlex.

  1. Article
  2. Improving Diabetes and Pre-Diabetes Detection in the UK: Insights From HbA1c Screening in an Acute Hospital's Emergency Department.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025
    Article
  3. Review
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

3 authors at 2 institutions in 1 country.

Sachiko OhdeGraduate School of Public Health, Clinical Epidemiology and HTA Center St. Luke's International University, 3-6-2 Akashi-cho, Chuo, Tokyo, 104-0044, Japan. saohde@luke.ac.jp.ORCID http://orcid.org/0000-0001-9137-0047
Kensuke MoriwakiComprehensive Unit for Health Economic Evidence Review and Decision Support (CHEERS), Research Organization of Science and Technology, Ritsumeikan University, #209, Research Park Bid. No. 2, 134, Minami-machi, Chudoji, Simogyo-ku,, Kyoto, 600-8813, Japan.
Osamu TakahashiGraduate School of Public Health, Clinical Epidemiology and HTA Center St. Luke's International University, 3-6-2 Akashi-cho, Chuo, Tokyo, 104-0044, Japan.
St. Luke's International University · JPRitsumeikan University · JP

Funding

Ministry of Education, Culture, Sports, Science and Technology 26860429
6 · The paper itself

Abstract

backgroundThe best HbA1c test interval strategy for detecting new type 2 diabetes mellitus (T2DM) cases in healthy individuals should be determined with consideration of HbA1c test characteristics, risk stratification towards T2DM and cost effectiveness.

methodsState transition models were constructed to investigate the optimal screening interval for new cases of T2DM among each age- and BMI-stratified health individuals. Age was stratified into 30-44-, 45-59-, and 60-74-year-old age groups, and BMI was also stratified into underweight, normal, overweight and obesity. In each model, different HbA1c test intervals were evaluated with respect to the incremental cost-effectiveness ratio (ICER) and costs per quality-adjusted life year (QALY). Annual intervals (Japanese current strategy), every 3 years (recommendations in US and UK) and intervals which are tailored to each risk stratification group were compared. All model parameters, including costs for screening and treatment, rates for complications and mortality and utilities, were taken from published studies. The willingness-to-pay threshold in the cost-effectiveness analysis was set to US $50,000/QALY.

resultsThe HbA1c test interval for detecting T2DM in healthy individuals varies by age and BMI. Three-year intervals were the most cost effective in obesity at all ages-30-44: $15,034/QALY, 45-59: $11,849/QALY, 60-74: $8685/QALY-compared with the other two interval strategies. The three-year interval was also the most cost effective in the 60-74-year-old age groups-underweight: $11,377/QALY, normal: $18,123/QALY, overweight: $12,537/QALY-and in the overweight 45-59-year-old group; $18,918/QALY. In other groups, the screening interval for detecting T2DM was found to be longer than 3 years, as previously reported. Annual screenings were dominated in many groups with low BMI and in younger age groups. Based on the probability distribution of the ICER, results were consistent among any groups.

conclusionsThe three-year screening interval was optimal among elderly at all ages, the obesity at all ages and the overweight in 45-59-year-old group. For those sin the low-BMI and younger age groups, the optimal HbA1c test interval could be longer than 3 years. Annual screening to detect T2DM was not cost effective and should not be applied in any population.

Indexed as

AdultAgedCost-Benefit AnalysisDiabetes Mellitus, Type 2Glycated HemoglobinHumansMass ScreeningMiddle AgedRisk AssessmentGlycated Hemoglobinhemoglobin A1c protein, humanCost effectiveness analysisHbA1c measurementType 2 diabetes mellitus screening

Identifiers

PMID34022872
PMCPMC8141129
OpenAlexW3165486443

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.