Evidence map›Paper›PMID 41361041›Full record

ArticleJournal of general internal medicine2026

Cost-Effectiveness of Primary Prevention of Stroke in Type 2 Diabetes in the United States: A Microsimulation Analysis.

Wen Ye, Xiaqing Jiang, Jing Li, Shihchen Kuo, Christopher J Becker, William H Herman, Weizhou Zhang, Lewis B Morgenstern, Lynda D Lisabeth

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

1 citing paper in PubMed.

  1. 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.

Wen YeDepartment of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA. wye@umich.edu.ORCID 0000-0001-5802-189X
Xiaqing JiangDepartment of Psychology, University of California San Francisco, San Francisco, CA, USA.
Jing LiDepartment of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Shihchen KuoDepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Christopher J BeckerDepartment of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA.
William H HermanDepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Weizhou ZhangDepartment of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Lewis B MorgensternDepartment of Neurology, University of Michigan Medical School, Ann Arbor, MI, USA.
Lynda D LisabethDepartment of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.

Funding

Division of Diabetes, Endocrinology, and Metabolic Diseases P30DK092926NINDS NIH HHS R21 NS120223
6 · The paper itself

Abstract

backgroundImplementation of guideline-recommended strategies to prevent acute ischemic stroke (AIS) in type 2 diabetes (T2D) remains suboptimal.

objectivesWe evaluated and compared the health impact and cost-effectiveness of improved implementation of guideline-recommended strategies for AIS prevention in patients with T2D in the United States.

designWe compared scenarios with enhanced implementation of these prevention strategies to the status-quo using a microsimulation model.

participantsNational Health and Nutrition Examination Survey (NHANES) 2015-2018 participants ≥ 45 years of age with T2D and no stroke history. MAIN MEASURES: We evaluated stroke-related events, costs, stroke-related quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios, and net health benefit (NHB) from a health system perspective over a 10-year time horizon. A discount rate of 3% per year was applied to costs and QALYs. Costs were expressed in 2022 U.S. dollars. KEY

resultsFull implementation of guideline-recommended blood pressure (BP), statin, and aspirin therapies, and smoking cessation would each be cost-saving or highly cost-effective (< $50,000 per QALY-gained). Over 10 years, full implementation of all four of the strategies would prevent 151,000 stroke events, 61,900 deaths from stroke, save $13.4 billion, and produce a nationwide increase of 1,552,000 QALYs (NHB).

conclusionsRecent attention has focused on the treatment of AIS. We demonstrate that substantial opportunities exist to improve the primary prevention of AIS in Americans with T2D. Providers and payers should prioritize adherence to guidelines for BP, statin and aspirin therapy, and smoking cessation for stroke prevention.

Indexed as

Cost-Benefit AnalysisDiabetes Mellitus, Type 2Ischemic StrokePrimary PreventionStrokeAgedAspirinComputer SimulationFemaleHumansMaleMiddle AgedNutrition SurveysQuality-Adjusted Life YearsUnited StatesAspirinacute ischemic strokecost-effectivenesspreventiontype 2 diabetes

Identifiers

PMID41361041
PMCPMC13176362

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.