Evidence map›Paper›PMID 37960938›Full record

ArticleInternational journal of technology assessment in health care2023

Cost-effectiveness of population-based screening for microalbuminuria in people with type 2 diabetes mellitus in India.

Sudalaimuthu Mathan Kumar, Saravanan Essakky, Subramania R Rajasulochana, Sitanshu Sekhar Kar, Parthibane Sivanatham, Jeyanthi Anandraj, Sreejith Parameswaran, Biju Soman, Kavitha Rajsekhar, Antony Stanley

Open access · greenAbstract read
In one paragraph

Article in International journal of technology assessment in health care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. 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

10 authors at 3 institutions in 1 country.

Sudalaimuthu Mathan KumarDepartment of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Saravanan EssakkyDepartment of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Subramania R RajasulochanaDepartment of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Sitanshu Sekhar KarDepartment of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.ORCID https://orcid.org/0000-0001-7122-523X
Parthibane SivanathamDepartment of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Jeyanthi AnandrajDepartment of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Sreejith ParameswaranDepartment of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Biju SomanAchutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India.
Kavitha RajsekharDepartment of Health Research, Government of India, New Delhi, India.
Antony StanleyAchutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India.
Jawaharlal Institute of Post Graduate Medical Education and Research · INSree Chitra Thirunal Institute for Medical Sciences and Technology · INGovernment of India · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesPatients with diabetes have a higher risk of developing chronic kidney disease (CKD). Early detection of CKD through microalbuminuria screening, followed by treatment, delays the progression of CKD. We evaluated the cost-effectiveness of population-based screening of microalbuminuria among normotensive type 2 diabetes mellitus patients aged >40 years compared with no screening scenario using a decision tree combined with the Markov model.

methodsWe considered two scenarios: Scenario I - dipstick microalbuminuria followed by spot-urine albumin-creatinine ratio (ACR) and serum creatinine in sequence; Scenario II - spot urine ACR plus serum creatinine. A mathematical cohort of the target population was simulated over a lifetime horizon with an annual cycle. Data for the model were obtained from secondary resources. The incremental cost-effectiveness ratios (ICERs) were estimated for screening scenarios compared to nonscreening scenario, along with sensitivity analyses.

resultsThe discounted ICER per quality-adjusted life years gained for annual microalbuminuria screening in the normotensive diabetic population in India were ₹ 24,114 (US$ 308) and ₹ 13,790 (US$ 176) for scenarios I and II, respectively. Annual screening by scenarios I and II resulted in a reduction of 180 and 193 end-stage renal disease (ESRD) cases per 100,000 population, respectively, resulting in a cost saving of ₹ 12.3 and 13.3 Crore spent on ESRD management over 10 years. Both scenarios were also cost-effective even at the screening frequencies of 5 and 10 yearly.

conclusionMicroalbuminuria screening was cost-effective at the threshold of one-time GDP per capita in India.

Indexed as

Diabetes Mellitus, Type 2Kidney Failure, ChronicRenal Insufficiency, ChronicCost-Benefit AnalysisCreatinineHumansMass ScreeningQuality-Adjusted Life YearsCreatininechronic kidney diseasecost-effectiveness analysiseconomic evaluationpopulation-based screeningtype 2 diabetes mellitus

Identifiers

PMID37960938
PMCPMC11579677
OpenAlexW4388660676

What Socratic holds

Textmetadata
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.