PDF(Pubmed)
Abstract：
UNASSIGNED: Point-of-care Testing (POCT) glycosylated hemoglobin (HbA1c) is a convenient, cheap, effective and accessible screening method for type 2 diabetes in rural areas and community settings that is widely used in the European region and Japan, but not yet widespread in China. The study is the first to evaluate the cost-effectiveness of POCT HbA1c, fasting capillary glucose (FCG), and venous blood HbA1c to screen for type 2 diabetes in urban and rural areas of China, and to identify the best socio-economically beneficial screening strategy.
UNASSIGNED: Based on urban and rural areas in China, economic models for type 2 diabetes screening were constructed from a social perspective. The subjects of this study were adults aged 18-80 years with undiagnosed type 2 diabetes. Three screening strategies were established for venous blood HbA1c, FCG and POCT HbA1c, and cost-effectiveness analysis was performed by Markov models. One-way sensitivity analysis and probabilistic sensitivity analysis were performed on all parameters of the model to verify the stability of the results.
UNASSIGNED: Compared with FCG, POCT HbA1c was cost-effective with an incremental cost-utility ratio (ICUR) of $500.06/quality-adjusted life year (QALY) in urban areas and an ICUR of $185.10/QALY in rural areas, within the willingness-to-pay threshold (WTP = $37,653). POCT HbA1c was cost-effective with lower cost and higher utility compared with venous blood HbA1c in both urban and rural areas. In the comparison of venous blood HbA1c and FCG, venous blood HbA1c was cost-effective (ICUR = $20,833/QALY) in urban areas but not in rural areas (ICUR = $41,858/QALY). Sensitivity analyses showed that the results of the study were stable and credible.
UNASSIGNED: POCT HbA1c was cost-effective for type 2 diabetes screening in both urban and rural areas of China, which could be considered for future clinical practice in China. Factors such as geographic location, local financial situation and resident compliance needed to be considered when making the choice of venous blood HbA1c or FCG.
UNASSIGNED: Based on urban and rural areas in China, economic models for type 2 diabetes screening were constructed from a social perspective. The subjects of this study were adults aged 18-80 years with undiagnosed type 2 diabetes. Three screening strategies were established for venous blood HbA1c, FCG and POCT HbA1c, and cost-effectiveness analysis was performed by Markov models. One-way sensitivity analysis and probabilistic sensitivity analysis were performed on all parameters of the model to verify the stability of the results.
UNASSIGNED: Compared with FCG, POCT HbA1c was cost-effective with an incremental cost-utility ratio (ICUR) of $500.06/quality-adjusted life year (QALY) in urban areas and an ICUR of $185.10/QALY in rural areas, within the willingness-to-pay threshold (WTP = $37,653). POCT HbA1c was cost-effective with lower cost and higher utility compared with venous blood HbA1c in both urban and rural areas. In the comparison of venous blood HbA1c and FCG, venous blood HbA1c was cost-effective (ICUR = $20,833/QALY) in urban areas but not in rural areas (ICUR = $41,858/QALY). Sensitivity analyses showed that the results of the study were stable and credible.
UNASSIGNED: POCT HbA1c was cost-effective for type 2 diabetes screening in both urban and rural areas of China, which could be considered for future clinical practice in China. Factors such as geographic location, local financial situation and resident compliance needed to be considered when making the choice of venous blood HbA1c or FCG.
摘要：
■即时检测（POCT）糖化血红蛋白（HbA1c）是一种方便，便宜,在欧洲地区和日本广泛使用的农村地区和社区环境中有效且易于使用的2型糖尿病筛查方法，但在中国还不普遍。该研究是第一个评估POCTHbA1c成本效益的研究，空腹毛细血管葡萄糖（FCG），和静脉血HbA1c筛查中国城乡2型糖尿病，并确定最佳的社会经济利益筛查策略。
■基于中国的城乡，从社会角度构建2型糖尿病筛查的经济模型.这项研究的受试者是18-80岁的未诊断为2型糖尿病的成年人。针对静脉血HbA1c建立了三种筛查策略，FCG和POCTHbA1c，并通过马尔可夫模型进行成本效益分析。对模型的所有参数进行了单向敏感性分析和概率敏感性分析，以验证结果的稳定性。
■与FCG相比，POCTHbA1c具有成本效益，城市地区的增量成本效用比（ICUR）为500.06美元/质量调整生命年（QALY），农村地区的ICUR为185.10美元/QALY，在支付意愿门槛内(WTP=37,653美元)。与城市和农村地区的静脉血HbA1c相比，POCTHbA1c具有较低的成本效益和较高的实用性。在静脉血HbA1c和FCG的比较中，静脉血HbA1c在城市地区具有成本效益(ICUR=$20,833/QALY),而在农村地区则不具有成本效益(ICUR=$41,858/QALY).敏感性分析表明，研究结果稳定可靠。
■POCTHbA1c在中国城市和农村地区的2型糖尿病筛查中具有成本效益，这可以考虑在中国未来的临床实践。地理位置等因素，在选择静脉血HbA1c或FCG时，需要考虑当地的财务状况和居民的依从性。
■基于中国的城乡，从社会角度构建2型糖尿病筛查的经济模型.这项研究的受试者是18-80岁的未诊断为2型糖尿病的成年人。针对静脉血HbA1c建立了三种筛查策略，FCG和POCTHbA1c，并通过马尔可夫模型进行成本效益分析。对模型的所有参数进行了单向敏感性分析和概率敏感性分析，以验证结果的稳定性。
■与FCG相比，POCTHbA1c具有成本效益，城市地区的增量成本效用比（ICUR）为500.06美元/质量调整生命年（QALY），农村地区的ICUR为185.10美元/QALY，在支付意愿门槛内(WTP=37,653美元)。与城市和农村地区的静脉血HbA1c相比，POCTHbA1c具有较低的成本效益和较高的实用性。在静脉血HbA1c和FCG的比较中，静脉血HbA1c在城市地区具有成本效益(ICUR=$20,833/QALY),而在农村地区则不具有成本效益(ICUR=$41,858/QALY).敏感性分析表明，研究结果稳定可靠。
■POCTHbA1c在中国城市和农村地区的2型糖尿病筛查中具有成本效益，这可以考虑在中国未来的临床实践。地理位置等因素，在选择静脉血HbA1c或FCG时，需要考虑当地的财务状况和居民的依从性。
