Evidence map›Paper›PMID 41661522›Full record

ArticlePharmacoEconomics2026

Development of a Patient-Level Multi-objective Optimisation Model for Screening Strategies for Childhood Type 1 Diabetes.

Gonçalo Leiria, R Brett McQueen, Conner Jackson, Marian Rewers, William A Hagopian, Richard A Oram, Jonathan E Fieldsend, Lauric A Ferrat

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In one paragraph

Article in PharmacoEconomics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. 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

5 · Who and what money

Authors and funding

8 authors.

Gonçalo Leiria *Department of Computer Science, University of Exeter, Exeter, UK.
R Brett McQueen *Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Conner JacksonSkaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Marian RewersBarbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
William A HagopianSchool of Medicine, Indiana University, Indianapolis, USA.
Richard A OramMedical School, University of Exeter, Exeter, UK.
Jonathan E Fieldsend *Department of Computer Science, University of Exeter, Exeter, UK. j.e.fieldsend@exeter.ac.uk.ORCID http://orcid.org/0000-0002-0683-2583
Lauric A Ferrat *Medical School, University of Exeter, Exeter, UK.

Funding

Breakthrough T1D 2-SRA-2024-1620-S-BJDRF 2-SRA-2022-1261-S-B
6 · The paper itself

Abstract

objectiveTo develop a patient-level simulation model of type 1 diabetes (T1D) covering both childhood and adulthood. The goal is to identify and evaluate the cost-effectiveness of optimal screening for pre-symptomatic T1D.

methodsWe developed a Python-based simulation model to track 100,000 participants screened in childhood, capturing a subset of those at risk and transitioning to T1D, to estimate the incremental cost-effectiveness per life year gained of screening versus no screening. Our multi-objective optimisation approach sought to minimise three objectives: incremental cost effectiveness ratio, diabetic ketoacidosis (DKA) events at onset and the maximum number of screening tests a child can have with the healthcare system. The NSGA-II algorithm is used to explore the set of possible screening strategies from combinations of genetic risk score (GRS) and islet autoantibody (IA) measurements at different ages and frequencies during the first 15 years of life. Data for transition probabilities include large scale screening studies such as The Environmental Determinants of Diabetes in the Young, TrialNet, published risk functions, clinical trials and epidemiologic studies.

resultsWe illustrate the use of multi-objective optimisation in patient-level simulations by estimating an optimal subset of T1D screening strategies in the USA. We identify four screening strategies with incremental cost-effectiveness ratios that meet commonly cited cost-effectiveness thresholds, which require, respectively, a maximum of 1, 2 3 and 4 islet autoantibody (IA) tests.

conclusionsThis article and corresponding model code can be used as a reference for implementing a multi-objective optimisation pipeline in patient-level simulation models.

Indexed as

Diabetes Mellitus, Type 1Mass ScreeningAdolescentAlgorithmsAutoantibodiesChildChild, PreschoolComputer SimulationCost-Benefit AnalysisCost-Effectiveness AnalysisDiabetic KetoacidosisHumansInfantAutoantibodies

Identifiers

PMID41661522

What Socratic holds

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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.