| Targeted diabetes screening seen
best
NEW YORK (Reuters Health) - The balance between the costs and benefits
of screening for diabetes is most favorable when efforts focus on
older individuals with high blood pressure, new research suggests.
In contrast, testing everyone for diabetes -- that is, universal
screening -- is not cost-effective, Dr. Thomas J. Hoerger, from
RTI International in Research Triangle Park, North Carolina, and
colleagues report in the Annals of Internal Medicine.
Hoerger's team estimated the costs and benefits of the two approaches
using special statistical tests and known healthcare costs.
At all ages, "diabetes screening targeted at persons with
(high blood pressure) is more cost-effective than screening the
general population," Hoerger told Reuters Health. All things
being equal, thousands of dollars can be saved by screening an older
patient with high blood pressure than screening one without this
problem.
In an editorial, Dr. David M. Nathan of Massachusetts General Hospital
in Boston and Dr. William H. Herman of the University of Michigan
in Ann Arbor, note that the rationale for any screening program
is that earlier detection will lead to earlier treatment.
"Unfortunately, the current state of delivery of care to persons
with diagnosed diabetes in the United States does not bode well
for the treatment of patients identified through screening,"
they write. "Unless we optimize care after we diagnose diabetes,
screening cannot be effective or cost-effective."
SOURCE: Annals of Internal Medicine, May 4, 2004.
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